Bloomberg 2012

Annual Filing for Charitable OrganizationsForm CHAR500

New York State Department of Law (Office of the Attorney General)Charities Bureau - Registration Section

This form used for 120 BroadwayArticle 7-A, EPIL and dual filers New Yo, NY 10271

(replaces forms CHAR 497,MAD nm rwAD nnr, http://www.charitiesnys.com

1. General Information

a. For the fiscal year beginning (mm/ddlyyyy) 01/

and

b. Check if applicable for NYS: c. Name of organization

Address change

Name change THE BLOOMBERG FAMILY FOUNDATION INCInitial filing

Final filing Number and street (or P.O. box if mail not delivered to street address) Room/suite

Amended filing C/O GELLER & CO, 909 THIRD AVE 116 FLNY registration pending City or town, state or country and ZIP + 4

2012

Open to Public

Inspection

d. Fed. employer ID no. (EIN)20-5602483

e. NY State registration no.40-57-41f. Telephone number212 205-0100g. Email

N/A

2. Certification - Two Signatures Required

We certify under penalties of perjury that we reviewed this report, including all attachments, and to the best of our knowledge and belief, they aretrue, correct and complete in accordance h hR laws of the State f N w York applicable to this report.

T

11112-11-3i

b. Chief Financial Officer orTreas. MICHAEL Nam:

BLOOMBERG AUTH SIGNER

3. Annual Report Exemption Information

a. Article 7-A annual report exemption (Article 7-A registrants and dual registrants)

Check *

if total contributions from NY State (including residents, foundations, corporations, government agencies, etc.) did not exceed$25,000 and the organization did not engage a professional fund raiser (PFR) or fund raising counsel (FRC) to solicitcontributions during this fiscal year.

NOTE: An organization may claim this exemption if no PFR or FRC was used and either: 1) it received an allocation from afederated fund, United Way or incorporated community appeal and contributions from other sources did not exceed$25,000 or 2) it received all or substantially all of its contributions from one government agency to which it submitted anannual report similar to that required by Article 7-A.

b. EPTL annual report exemption (EPTL registrants and dual registrants)

Check *= if gross receipts did not exceed $25,000 and assets (market value) did not exceed $25,000 at anytime during this fiscal year.

For EPTL or Article 7-A registrants claiming the annual report exemption under the one law under which they are registered and for dual registrants claiming the annualreport exemptions under both laws, simply complete part 1 (General Information), part 2 (Certification) and part 3 (Annual Report Exemption Information) above.

QQ not submit a fee, Ug n complete the following schedules and do not submit any attachments to this form.

4. Article 7-A Schedules

If you did not check the Article 7-A annual report exemption above, complete the following for this fiscal year:a. Did the organization use a professional fund raiser, fund raising counsel or commercial co-venturer for fund raising activity in NY State? •. Yes No

* If "Yes", complete Schedule 4a.

b. Did the organization receive government contributions (grants)? Yes No* If "Yes", complete Schedule 4b.

5. Fee Submitted: See last page for summary of fee requirements.

Indicate the filing fee(s) you are submitting along with this form:

a. Article 7-A filing fee ..........................................................................................$ Submit only one check or money order for the

b. EPTL filing fee ................................................................................................... $ 1,500. total fee, payable to "NYS Department of Law'

c. Total fee ......................................................................................................... $1,500.

6. Attachments - For organizations that are not claiming annual report exemptions under both laws, see last page for required attachments 0, 0 0 I

2684511 01-21-13 1019 CHAR500-2012

215141028 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA1

THE BLOOMBERG FAMILY JNDATION INC5. Fee Instructions

The filing fee depends on the organizations Registration Type. For details on Registration Type and filing fees, see the Instructions for

Form CHAR500.

Organization's Registration Type Fee Instructions

• Article 7-A

• EPTL

• Dual

a) Article 7-A filing fee

Calculate the Article 7-A filing fee using the table in part a below. The EPTL filing fee is $0.

Calculate the EPTL filing fee using the table in part b below. The Article 7-A filing fee is $0.

Calculate both the Article 7-A and EPTL filing fees using the tables in parts a and b below. Add the Article 7-Aand EPTL filing fees together to calculate the total fee. Submit a single check or money order for the total fee.

Total Support & Revenue Article 7-A Fee l Any organization that contracted with or used the services of a professional fund raisermore than $250,000 $25 (PFR) or fund raising counsel (FRC) during the reporting period must pay an Article 7-Aup to $250,000 * $10 filing fee of $25, regardless of total support and revenue.

b) EPTL filing fee

6. Attachments - Document Attachment Check-List

Check the boxes for the documents you are attaching.

For All Filers

Filing Fee

Single check or money order payable to "NYS Department of Law

Copies of Internal Revenue Service Forms

IRS Form 990All required schedules (includingSchedule B)

LIII IRS Form 990-T

IRS Form 990-EZAll required schedules (includingSchedule B)IRS Form 990-T

IRS Form 990-PFL1 All required schedules (including

Schedule B)EIII IRS Form 990-T

Additional Article 7-A Document Attachment Requirement

Independent Accountant's Report

ED Audit Report (total support & revenue more than $250,000)

ED Review Report (total support & revenue $100,001 to $250,000)

No Accountant's Report Required (total support & revenue not more than $100,000)

10194 288481 01-21-13 CHAR500 - 2012


Geller & Company

Via Certified Mail

August 8, 2013

Office of Attorney GeneralCharities Bureau Dept.120 Broadway, 3rd FloorNew York, NY 10271

Re: The Bloomberg Family Foundation Inc.E1N 20-56024832012 Char-500NYS Reg. #40-57-41

Dear Sir/Madam:

We respectfully request an additional three months extension of time to file until November15, 2013 for the above referenced foundation. A federal extension request for an additional3-month extension of time was timely filed on Form 8868. The reason for the extension isdue to all information necessary to file a complete and accurate tax return is not yetavailable.

Attached please find a copy of the Internal Revenue Service Form 8868 submitted by theBloomberg Family Foundation Inc.

Please contact us at (212) 583-6000 should you need additional information.

Sincerely,

Charles Pomo

Enclosures

FiIes\Content.Outlook\9186426N\CHAR500 2nd extension Ietter.docx909 Third Avenue • New York, NY 10022

212.583.6000 tel • www.gellerco.com

Form 8868 (Rev. 1-2013) Page

• If you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part If and check this box**Note. Only complete Part II if you have already been granted an automatic 3-month extension on a previously filed Form 8668.• If you are filing for an Automatic 3-Month Extension, complete only Part I (on page 1).

Part Ill Additional (Not Automatic) 3 -Month Extension of Time. Only file the original (no copies needed).Enter filer's ldentifvina number. see Instructions

Type or

print

File by the

due date for

filing your

return. See

instructions.

Name of exempt organization or other filer, see instructions

BLOOMBERG FAMILY FOUNDATION INCNumber, street, and room or suite no. If a P.O. box, see instructions./0 GELLER & CO, 909 THIRD AVE. NO. 16 FLCity, town or post office, state, and ZIP code. For a foreign address, see instructions.EW YORK, NY 10022

Employer identification number (EIN) or

20-56 02483Social security number (SSN)

Enter the Return code for the return that this application is for (file a separate application for each return) I 0 I 41

Application

Return I Application

ReturnIs For

or Form 990•EZ

02 I Form lO41-AForm 4720 (ii

Form 990-PF

05 I Form 606906 I Form 887O

08

11

12STOP! Do not complete Part II if you were not already granted an automatic 3-month extension on a previously filed Form 8868.

DIANE GtJBELLI, C /O GELLER & CO LLC• The books are lnthe care of 909 THIRD AVENUE, 16TH FL - NEW YORK, NY 10022

TelephoneNo. 212-583-6000 FAXNo. lo. 2l2583624l• If the organization does not have an office or place of business In the United States, check this box IJJ• If this is for a Group Return, enter the organizations four digit Group Exemption Number (GEN) ________ If this Is for the whole group, check thisbox . If it is for part of the group, check this box 0, Ej and attach a list with the names and EINs of all members the extension Is for.4 I request an additional 3-month extension of time until NOVEMBER 15, 2013.5 For calendar year 2012 , or other tax year beginning , and ending6 If the tax year entered In line 5 is for less than 12 months, check reason: L..J Initial return =Final return

Change in accounting period

7 State in detail why you need the extensionAN ADDITIONAL EXTENSION OF TIME IS REQUIRED TO FILE A COMPLETE ANDACCURATE RETURN BECAUSE ALL INFORMATION IS NOT AVAILABLE.

8a If this application is for Form 990-13L, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less anynonrefundable credits. See instructions.

b If this application is for Form 990•PF, 990-1, 4720, or 6069, enter any refundable credits and estimated

tax payments made. Include any prior year overpayment allowed as a credit and any amount paid

Balance due. Subtract line 8b from line 8a. Include your payment with this form, if required, by usingEFTPS (Electronic Federal Tax

nd Verification must be completed for Part II only.this form, including accompanying schedules and statements, and to the best of myto prepare this form.

Title CPA

22384201-21-13

Under penalties of perjury, I declare that Iit is true, correct, anji1te, anI4hat I

4,612,153.

4,612,153.

0.

dg and belief,

18668 (Rev. 1.2013)


.

Castro, Susan

From: Castro, SusanSent: Monday, May 13, 2013 11:19 AMTo: [email protected]: Porno, Charles; Jacaruso, JamesSubject: The Bloomberg Family Foundation, Inc., NYS Reg No.40-57-41, EIN# 20-5602483Attachments: FORM 8868 BFF 990-PF due 8.15.12.PDF

We respectfully request an extension of time to file the annual report for the year ended December 31, 2012 Form CHAR500 untilAugust 15, 2013 for The Bloomberg Family Foundation, Inc., because all information necessary to file a complete and accuratereturn is not available.

We have also attached a copy of the 2012 Internal Revenue Service Form 8868, Application for Extension of Time to File an ExemptOrganization Return, submitted by The Bloomberg Family Foundation, Inc.

Susan CastroGeller Family Office Services LLCa suhsidhir of Geller & Cnmpanv LIE

909 Third Avenue - 16th FloorNew York, NY 10022212.583.6062 Officewww.gellerfamilvofficeservices.com

I 0Form 8868(Rev. January 2013)Department of the TreasuryInternal Revenue Service

Application for Extension of Time To File anExempt Organization Return

File a

for each return.

OMB No. 1545-1709

• If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box EXI• If you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part II (on page 2 of this form).

Do not complete Part II unless you have already been granted an automatic 3-month extension on a previously filed Form 8868.Electronic filing (e-fl/e) . You can electronically file Form 8868 if you need a 3-month automatic extension of time to file (6 months for a corporationrequired to file Form 990-1), or an additional (not automatic) 3-month extension of time. You can electronically file Form 8868 to request an extension

of time to file any of the forms listed in Part I or Part II with the exception of Form 8870, Information Return for Transfers Associated With Certain

Personal Benefit Contracts, which must be sent to the IRS in paper format (see instructions). For more details on the electronic filing of this form,visit wwvi'irs.gov/eflle and click on e-file for Charities & Nonprofits.

I Part I I Automatic 3-Month Extension of Time. Only submit original (no copies needed).A corporation required to file Form 990-T and requesting an automatic 6-month extension - check this box and completePart lonly

All other corporations (including 1120-C fliers), partnerships, REM/Cs, and trusts must use Form 7004 to request an extension of timeto file income tax returns.

Type or Name of exempt organization or other filer, see instructions.print

THE BLOOMBERG FAMILY FOUNDATION INCFile by thedue date for Number, street, and room or suite no. If a P.O. box, see instructions.filing your GELLER & CO, 909 THIRD AVE, NO. 16 FLreturn. Seeinstructions. City, town or post office, state, and ZIP code. For a foreign address, see instructions.

NEW YORK, NY 10022


20-5602483Social security number (SSN)

Enter the Return code for the return that this application is for (file a separate application for each return) I 0 I 4 I

Application Return Application ReturnIs For Code Is For CodeForm 990 or Form 990-EZ

01 Form 990-T(l 07Form 990-BL

02 Form 1041-A

08Form 4720 (individual)

03 Form 4720

09Form 990-PF

04 1 Form 5227Form 990-T (sec. 401 (a) o

05 Form 6069Form 990-T (trust other than above) I 06 I Form 8870 I 12

DIANE GUBELLI, C/O GELLER & CO LLC• Thebooksareinthecareof 909 THIRD AVENUE, 16TH FL - NEW YORK, NY 10022

TelephoneNo* 2125836000 FAXNo." 2125836241• If the organization does not have an office or place of business in the United States, check this box• If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN) - If this is for the whole group, check thisbox El. If it is for part of the group, check this box No. El and attach a list with the names and EINs of all members the extension is for.

1 I request an automatic 3-month (6 months for a corporation required to file Form 990-1) extension of time untilAUGUST 15, 2013 , to file the exempt organization return for the organization named above. The extension

is for the organization's return for:

p -EXI calendar year 2Ol2 orE1 tax year beginning , and ending

2 If the tax year entered in line 1 is for less than 12 months, check reason: El Initial return El Final returnEl Change in accounting period

3a If this application is for Form 990-BL, 990-PF, 990-1, 4720, or 6069, enter the tentative tax, less anyrefundable credits. See instructions. $ 2,900,515.

If this application is for Form 990-PF, 990-1, 4720, or 6069, enter any refundable credits andestimated tax payments made. Include any prior year overpayment allowed as a credit. I $ 3,112,153.Balance due. Subtract line 3b from line 3a. Include your payment with this form, if required,by using EFTPS (Electronic Federal Tax Payment System). See instructions. I 3c I $ 0

Caution. If you are going to make an electronic fund withdrawal with this Form 8868, see Form 8453-EQ and Form 8879-EQ for payment instructions.LHA For Privacy Act and Paperwork Reduction Act Notice, see instructions. Form 8868 (Rev. 1-2013)

22384101-21-13


Return of Private Foundationor Section 4947(a)(1) Nonexempt Charitable Trust

Treated as a Private FoundationNote. The foundation may be able to use a copy of this return to satisfy state reporting n

ir beginning . and endina

Form 990-PFDepartment of the Treasury

For calendar year 2012 or tax

Name of foundation

2012Employer identification number

INC

0-5602483Number and street (or P.O. box number if mail is not delivered to street address)

Roomsuite B Telephone number

C/a GELLER & CO, 909 THIRD AVE

16 FL 212-205-0100City ortown, state, and ZIP code

C If exemption application is pending, check here

13 Check all that apply., U Initial return U Initial return of former public charity

LI Final return LI Amended return

LI Address change El Name change

H Check type of organization: LIII Section 501(c)(3) exempt private foundation

L11 Section 4947(a)(1) nonexempt charitable trust LII] Other taxable private foundation

I Fair market value of all assets at end of yearJ Accounting method: W Cash El Accrual

(front Part II, Col.(c), line 16) El Other (specify)

4,242,746,954. (Part!, column (d) must be on cash basis.)Part I

(flie total of amounts in columns (c and (d) may notexpenses per books

(b) N etnecessarily equal the amounts In column (s^)

I Contributions, gifts, grants, etc., received .998 , 378,348 .12 Check El n the fovndalion is not required to attach Sch. a

interest on savien ts

ngs ..

and t' a

emporarycsh inves tm

..... .... . ............

...................__________

4 Dividends and interest from securities

156 ,

347 , 6

5a Gross rents

b Net rental income or foss)

62 Net gain or Voss) from sale of assets not on line 10 ..Gross sales price for all

1 3 # 300,,000.U assets on line 6a

gl 7 Capital gain net income (from Part IV tine 2)

8 Net short-term capital gain

9 Income modifications .................................... .________Gross sales less returns

lOa and allowances ............

b Less: Cost of goods sold

o Gross profit or (loss)

11 Other income 2,1- 12 Total. Add lines 1 through 11 1 20

13 Compensation of officers, directors, trustees, etc 114 Other employee salaries and wages

15 Pension plans, employee benefits

l6a Legal fees STMT 5 3b Accounting fees STMT s 5c Other professional fees S.'IMT 7

17 Interest 51818 Taxes S.TMT s 2,619 Depreciation and depletion

20 Occupancy

< 21 Travel, conferences, and meetings 188 , 361.22 Printing and publications .____________________

23 Other expenses STMT ...9 31,845,699.24 Total operating and administrative

CL expenses. Add lines 13 through 23

131 , 263 , 38 6

.41,664,753.0 25 Contributions, gifts, grants paid .

26 Total expenses and disbursements.

- Add lines 24 and 25 172,928,139.27 Subtract line 26 from line 12:

a Excess of revenue over expenses and disbursements 1.031.580.408.

b Net investment income ft negative, enter -0-)

- C Adjusted net income ft negative. enter -U-) ............ .

.

-05-12 LHA For Paperwork Reduction Act Notice, see instructions.

1. Foreign organizations, check here

2. Foreign organizations meeting the 85% test,check here and attach computation

If private foundation status was terminatedunder section 507(b)(1)(A), check here ...El

lithe foundation is in a 60-month terminationunder section 507(b)(1)(B), check here ..r..El

(c) Adjusted net I (d) Disbursementsincome

for thar table purpos€

3

LIP

705.711.

Form 990-PF (2012)

5,122.4.091.

5

97,100. 49,275.

57,785. 0.

37,403. 237,452.

12,000. 0.

76,328. 5,876,328.

50,077. 477.707.


6.

1.28

SA"

FAMILY

11 11 ch lt2tf aouni to lltl)llon[part iiI Name Sheets

column should be for *ol'year amounts only.

1 Cash - non-interest-bearing .

2 Savings and temporary cash investments

3 Accounts receivable

Less: allowance for doubtful accounts

4 Pledges receivable

Less: allowance for doubtful accounts

5 Grants receivable

6 Receivables due from officers, directors, trustees, and other

disqualified persons

7 Other notes and loans receivable

Less: allowance for doubtful accounts 10,

8 Inventories for sale or use

9 Prepaid expenses and deferred charges

< ba Investments - U.S. and state government obligations STMT

b Investments - corporate stock

o Investments - corporate bonds

11 Investments -land, buildings, and equipment oasis

Less: accumulated depneciausn .

12 Investments - mortgage loans

13 Investments - other 12.14 Land, buildings, and equipment basis

Less:accumuiated depreciation

15 Other assets (describe

STIQN INC 20-

I'aij2Bekinino of year End of

(a Book Value (b) Book Value I

Fair Market Value

26.606

8,857.

9, 5 8,857.

17 Accounts payable and accrued expenses

18 Grants payable

19 Deferred revenue

20 Loans from officers, directors, trustees, and other disqualified persons

21 Mortgages and other notes payable

' 22 Other liabilities (describe lio .

Foundations that follow SFAS 117, check here LX]

U) and complete lines 24 through 26 and lines 30 and 31.

a)0 24 UnrestrictedC

25 Temporarily restricted(a

26 Permanently restricted

Foundations that do not follow SFAS 117, check hereC

U- and complete lines 27 through 31.I-0

27 Capital stock, trust principal, or current fundsa) 28 Paid-in or capital surplus, or land, bldg., and equipment fund(I,

29 Retained earnings, accumulated income, endowment, or other funds

30 Total net assets or fund balances

I Part Ill I Analysis of Changes in Net Assets or Fund Balances

I Total net assets or fund balances at beginning of year - Part II, column (a), line 30

(must agree with end-of-year figure reported on prior year's return)

2 Enter amount from Part I, line 27a

3 Other increases not included in line 2 (itemize) 0o.

4 Add lines l,2, and 3

5 Decreases not included in line 2 (itemize)

223511 Form 990-PF (2012)

12-05-12


(C) Date acquired (d) Date sold(mo., day, yr.) (mo., day, yr.)

3

I

Form 990-PF (2012) THE BLOONBERG FAMILY FOUNDATION

art IV Capital Gains and Losses for Tax on Investment Income(a) List and describe the kind(s) of property sold (e.g., real estate,2-story brick warehouse; or common stock, 200 shs. MLC Co.)

la

b SEE ATTACHED STATEMENTC

d

0

(e) Gross sales price (f) Depreciation allowed (g) Cost or other basis(or allowable) plus expense of sale

(h) Gain or (loss)(e) plus (f) minus (g)

13,300,000.1 1 13,300,000omplete only for assets showing gain in column (h) and owned by the foundation on 12/31/69

(j) Adjusted basis(k) Excess of cot. (i)(I) F.M.V. as of 12/31/69 as of 12/31/69 over cal. (j), if any

155,2(I) Gains (Col. (h) gain minus

col. (k), but not less than -0-) orLosses (from cal. (h))

[ If gain, also enter in Part I, line 7 I2 Capital gain net income or (net capital loss) 'j If (loss), enter -0- in Part I, line 7 .................. J ...j

3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):If gain, also enter in Part I, line 8, column (C).

I Part V I Quaiitication Under section 44U() tor ileciuceci lax on Net investment income(For optional use by domestic private foundations subject to the section 4940(a) tax on net investment income.)

If section 4940(d)(2) applies, leave this part blank.

Was the foundation liable for the section 4942 tax on the distributable amount of any year in the base period? ......... . fl Yes EE No

If "Yes,' the foundation does not qualify under section 4940(e). Do not complete this part.1 Enter the appropriate amount in each column for each year; see the instructions before making any entries.

(d)(a) (b) (0) Distribution ratioBase period yearsCalendar year for tax year beolnnina j Adjusted qualifying distributions I Net value of noncharitable-use assets col. (b) divided by col. (c)i

1

.040100• 04621• 05104.023970• 071795

• 233124

• 046625

354, 600 486.

156,408 ,248.

1,682,137.

158,090,385.

131.969.097.

83,945,446. 1,644,449,325.2008

31.690.900. 1.322.117.206.

2 Total of line 1, column (d) .......................................................................................................................2

8 Average distribution ratio for the 5-year base period - divide the total on line 2 by 5, or by the number of years

the foundation has been In existence if less than 5 years ..................................................8

4 Enter the net value of noncharitable-use assets for 2012 from Part X, line 5 4

5 Multiply line 4 by line 3 ....................................................................................................................................5

6 Enter 1% of net investment income (1% of Part I, line 27b) .6

7 Add lines 5 and 6 7

8 Enter qualifying distributions from Part XII, line 4 .8

If line 8 is equal to or greater than line 7, check the box in Part VI, line ib, and complete that part using a 1% tax rate.See the Part VI instructions.

223521 12-05-12 Form 990-PF (2012)

310531111 737725 BLOOMFANFND 2012.04040 THE BLOOMBERG FAMILY FOtJNDA BLOOMFA2

ONorni 990-PF

ax based on

1 a Exempt operating foundations described in section 4940(d)(2), check here L..J and enter 'N/A' on line 1.

Date of ruling or determination letter (attach copy of letter if necessary-see instructions)

b Domestic foundations that meet the section 4940(e) requirements in Part V, check here lo, and enter 1%

ofPart I, line 27b .....................................................................................................

c Al other domestic foundations enter 2% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b).

2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)

3 Add lines l and 2

4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)

5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0-

20-5602483 Page

or 4948 - see instructions)

,364,274.

66 Credits/Payments:

a 2012 estimated tax payments and 2011 overpayment credited to 2012 .........................6a 3,112,153b Exempt foreign organizations - tax withheld at source .6b

o Tax paid with application for extension of time to file (Form 8868) .6c 1,500,000d Backup withholding erroneously withheld .6d

7 Total credits and payments. Add lines 6a through 6d ........................................................................

8 Enter any penalty for underpayment of estimated tax. Check here i:i it Form 2220 is attached

9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed

10 Overpayment. It line 7 is more than the total of lines 5 and 8, enter the amount overpaid

la During the tax year, did the foundation attempt to influence any national, state, or local legislation or did it participate or intervene in

any political campaign?

b Did it spend more than $100 during the year (either directly or indirectly) for political purposes (see instructions for definition)? .............

If the answer is 'Yes' to la or ib, attach a detailed description of the activities and copies of any materials published ordistributed by the foundation in connection with the activities.

c Did the foundation file Form 1 120-POL for this year? .....................................................................................................................

d Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:

(1) On the foundation. $ 0 . (2) On foundation managers. $ 0e Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed on foundation

managers. $ 02 Has the foundation engaged in any activities that have not previously been reported to the IRS?

If 'Yes,' attach a detailed description of the activities.

3 Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles of incorporation, or

bylaws, or other similar instruments? If 'Yes,' attach a conformed copy of the changes

4a Did the foundation have unrelated business gross income of $1,000 or more during the year?

b It 'Yes,' has it filed a tax return on Form 990-1 for this year?

5 Was there a liquidation, termination, dissolution, or substantial contraction during the year?

If 'Yes,' attach the statement required by General instruction T.

6 Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:

• By language in the governing instrument, or

'By state legislation that effectively amends the governing instrument so that no mandatory directions that conflict with the state law

remain in the governing instrument?

7 Did the foundation have at least $5,000 in assets at any time during the year? ...............................................................................

If 'Yes,' complete Part II, col. (c), and Part Xt1Ba Enter the states to which the foundation reports or with which it is registered (see instructions) 10,

DE, NYb If the answer is 'Yes' to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney General (or designate)

of each state as required by General Instruction G? If 'No,' attach explanation9 Is the foundation claiming status as a private operating foundation within the meaning of section 4942(0(3) or 4942( j)(5) for calendar

year 2012 or the taxable year beginning in 2012 (see instructions for Part XIV)? If 'Yes,' complete Part XIV

Form 990-PF (2012)

4

4

22353112-c5-12

410531111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOONFA2

1i-560

Part VI-A I Statements Regarding Activities (continued) -11 At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the meaning of I 1

section 512(b)(13)? lf'Yes, attach schedule (see instructions)STATEMENT :La STATEMENT .4. ...... S.T ... . 5 I_il x -12 Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had advisory privileges?

ll'Yes,' attach statement (see instructions) - x

13 Did the foundation comply with the public inspection requirements for its annual returns and exemption application?[.13

Website address N/A

14 Thebooksarein care of Oo. DIANE GUBELLI, C/O GELLER & CO LLC Telephone no*212-583-6000

Locatedat909 THIRD AVENUE, 16TH FL, NEW YORK, NY ZIP+4 1002215 Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 - Check here

and enter the amount of tax-exempt interest received or accrued during the year L 15 I N/A -16 At any time during calendar year 2012, did the foundation have an interest in or a signature or other authority over a bank, Yes No

securities, or other financial account in a foreign country? L 16 XSeethe instructions for exceptions and tiling requirements for Form TO F 90-22.1. If 'Yes,' enter the name of the foreign

4720File Form 4720 if any item is checked in the "Yes" column, unless an exception applies. No

1 a During the year did the foundation (either directly or indirectly):

(1) Engage in the sale or exchange, or leasing of property with a disqualified person? Eli Yes E1 No(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)

a disqualified person? .Yes I1 No(3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? E1 Yes EJ No(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? I1 Yes El No(5) Transfer any income or assets to a disqualified person (or make any of either available

for the benefit or use of a disqualified person)? El Yes E1 No(6) Agree to pay money or property to a government official? (Exception. Check 'No'

if the foundation agreed to make a grant to or to employ the official for a period after

termination of government service, if terminating within 90 days.) .Yes El Nob It any answer is "Yes' to la(1)-(6), did any of the acts fail to quality under the exceptions described in Regulations

section 53.4941(d)-3 or in a current notice regarding disaster assistance (see instructions)?

lbOrganizations relying on a current notice regarding disaster assistance check here . ci

o Did the foundation engage in a prior year in any of the acts described in la, other than excepted acts, that were not corrected

before the first day of the tax year beginning in 2012?

ic2 Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private operating foundation

defined in section 4942(j)(3) or 4942(j)(5)):

a At the end of tax year 2012, did the foundation have any undistributed income (lines 6d and 6e, Part XIII) for tax year(s) beginning

before 2012? 11 Yes I1 NoIf 'Yes,' list the years

b Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2) (relating to incorrect

valuation of assets) to the year's undistributed income? (If applying section 4942(a)(2) to all years listed, answer 'No' and attach

statement - see instructions.) NL.Ac If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.

3a Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at any time

during the year? E1 Yes El Nob lf'Yes,' did it have excess business holdings in 2012 as a result of (1) any purchase by the foundation or disqualified persons after

May 26, 1969; (2) the lapse of the 5-year period (or longer period approved by the Commissioner under section 4943(c)(7)) to dispose

of holdings acquired by gift or bequest; or (3) the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C,Form 4720, to determine if the foundation had excess business holdings in 2012.)

4a Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?

b Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its charitable purpose that

Form 990-PF (2012)

22354112-05-12

510531111 737725 BLOOMFANFND 2012.04040 THE BLOOMBERG FAMILY FOTJNDA BLOOMFA2

(a) Name and address(b) Title, and averaoe (c) Cc

hours per week devdled (ifto position I e (e) Expense

account, otherallowances

Form 990-PF (2012)

enter NONE.N

(C) Compensation(e) Expense

account, otherallowances

n C

-5602for Which Form 4720 May Be

5a During the year did the foundation pay or incur any amount to:

(1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? El Yes FIl No(2) Influence the outcome of any specific public election (see section 4955); or to carry on, directly or indirectly,

any voter registration drive? El Yes [] No(3) Provide a grant to an individual for travel, study, or other similar purposes? .Yes E1 No(4) Provide a grant to an organization other than a charitable, etc., organization described in section

509(a)(1), (2), or (3), or section 4940(d)(2)? .Yes LI No(5) Provide for any purpose other than religious, charitable, scientific, literary, or educational purposes, or for

the prevention of cruelty to children or animals? El Yes Nob If any answer is Yes to 5a(1 )-(5), did any of the transactions fail to quality under the exceptions described in Regulations

section 53.4945 or in a current notice regarding disaster assistance (see instructions)?

Organizations relying on a current notice regarding disaster assistance check here 01.0c lithe answer is Yes to question 5a(4), does the foundation claim exemption from the tax because it

expenditure responsibility for the grant? .E.EEME [1 Yes El NoIt "Yes," attach the statement required by Regulations section 53.4945-5(d).

6a Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on

a personal benefit contract? El Yes [] Nob Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?

If Yes" to 6b, tile Form 8870.

7a At any time during the tax year, was the foundation a party to a prohibited lax shelter transaction? El Yes EiJ Noo ii-yes, aicc me tounuation receive an y proceeds or have any net income attributable to the transaction?

Information About Officers, Directors, Trustees, Foundation Managers, HighlyI Part VIII I Paid Employees, and ContractorsI List all

foundation managers and their

16

1

['p

2 pensatuon of live highest-paid employees (other than those Included on line I

(b) Title, and(a) Name and address of each employee paid more than $50,000 hoursper

devoted to o

22355112-05-12


Form S9O-PF(2012) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Page Information About Officers, Directors, Trustees, Foundation Managers, Highly

L!TaI. Paid Employees, and Contractors (continued)

3 Five highest-paid independent contractors for professional services. If none, enter "NONE."(a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation

GELIER & COMPANY - 909 THIRD AVE., 16TH 1FLOOR, NEW YORK, NY 10022 IA.CCOtJNTING 474,903.WILLKIE FARR & GALLAGHER LLP

A

fA

Part IX-A I summary 0? LHrect charitable ActivitiesList the foundation's four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses

N/A

2

3

4

I Part IX-13 I Summary of Program-Related InvestmentsDescribe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount

1 N/A

2

All other program-related investments. See instructions.

3

Form 990-PF (2012)

22356112-05-12

710531111 737725 BLOOMFANFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

Form 99O-PF(2012) THE BLOONBERG FAMILY FOUNDATION INC 20-5602483 Page

[irt X I Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)

1 Fair market value of assets not used (or held for use) directly in carrying out charitable, etc., purposes:

a Average monthly fair market value of securities ....................

b Average of monthly cash balances

c Fair market value of all other assets

dTotal (add lines la, b, and C) ...........................................................................................................

e Reduction claimed for blockage or other factors reported on lines la and

is (attach detailed explanation) ..................................................... I le I 02 Acquisition indebtedness applicable to line 1 assets ............................................................................................

3 Subtract line 2 from line id .....................................................................................................................

4 Cash deemed held for charitable activities. Enter 11/2% of line 3 (for greater amount, see instructions)

5 Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4

rpad xi Distributable Amount see instructions) (Section 4942(D(3) and (j)(5) private operating foundations and certain

foreign organizations check here fl and do not complete this part)

1 Minimum investment return from Part X, line ..................................1 167,730 , 024.2a Tax on investment income for 2012 from Part VI, line 5 .2a 3,364,274

b Income tax for 2012. (This does not include the tax from Part VI.) .2b

c Add lines 2a and 2b .20 3,364,274.

3 Distributable amount before adjustments. Subtract line 2c from line 1 .3 164,365,750

4 Recoveries of amounts treated as qualifying distributions ..............................................................................j... 0

5 Add lines 3 and 4 ................................................................................................ 5 164,365,750.6 Deduction from distributable amount (see instructions) .6 0

re and on Part XIII. line 17 Distributable amount as adiusted. Subtract line 6 from line 5. Enter he 7 164.365.750 -

Part XIIJ Qualifying Distributions (see instructions)

1 Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes: -

a Expenses, contributions, gifts, etc. - total from Part I, column (d), line 26 .la 131,969,097.

b Program-related investments - total from Part IX-B .lii 0

2 Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc., purposes .2

3 Amounts set aside for specific charitable projects that satisfy the:

a Suitability test (prior IRS approval required)

b Cash distribution test (attach the required schedule) .......................................................................................4 Qualifying distributions. Add lines la through 3b. Enter here and on Part V, line 8, and Part XIII, line 4 .....................4 131,969,097

5 Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment

income. Enter 1% of Part I, line 27b ..1 0

6 Adjusted qualifying distributions. Subtract line 5 from line 4 .6 131,969,097

Note. The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for the section

4940(e) reduction of tax in those years.

Form 990-PF (2012)

4

4,6

22357112-05-12


1 0r

Form 99O-PF(2012) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Pae9

rt ffJ Undistributed Income (see instructions)

(a) (b) (c)

(d)Corpus Years prior to2oll 2011

2012

I Distributable amount for 2012 from Part Xl,

line 7

2 Undslributed Income, any, as of the end of 2012:

a Enter amount for 2oll only

b Total for prior years:

[i

3 Excess distributions carryover, if any, to 2012:

a From 2007

b From 2008

c From 2009

d From 2OlO

e From 2011

f Total of lines 3a through e

4 Qualifying distributions for 2012 from

PartXll, line 4:$ 131 .969,097.a Applied to 2011, but not more than line 2a

b Applied to undistributed income of prior

years (Election required - see instructions)

c Treated as distributions out of corpus

(Election required - see instructions)

d Applied to 2012 distributable amount

TION

e Remaining amount distributed out of corpus

5 Excess distributions carryover applied to 2012

IMP(If on amount appears in column (4 the same amountmust be shown in column (a).)

6 Enter the net total of each column asindicated below:

a Corpus. Add lines 31, 40, and 4e. Subtract line 5

b Prior years undistributed income. Subtract

line 4b from line 2b

c Enter the amount of prior yearsundistributed income for which a notice ofdeficiency has been issued, or on whichthe section 4942(a) tax has been previouslyassessed

d Subtract line 6c from line 6b. Taxable

amount - see instructions

[iJe Undistributed income for 2011. Subtract line

4a from line 2a. Taxable amount - see instr.

f Undistributed income for 2012. Subtract

lines 4d and 5 from line 1. This amount must

be distributed in 2013

7 Amounts treated as distributions out of

corpus to satisfy requirements imposed by

section 170(b)(1)(F) or 4942(g)(3)

8 Excess distributions carryover from 2007

not applied on line 5 or line 7

9 Excess distributions carryover to 2013.

Subtract lines 7 and 8 from line Ba

10 Analysis of line 9:

a Excess from 2008

b Excess from 2009

o Excess from 2010...

d Excess from 2011

223581 Form 990-PF (2012)

12-05-12

910531111 737725 BLOOMFAMFND 2012.04040 THE BLOONBERG FAMILY FOUNDA BLOOMFA2

Form 990-PF

?AMILY FOUNDATION INC 10(see instructions and Part VU-A, question 9)

1 a lithe foundation has received a ruling or determination letter that it is private operating

foundation, and the ruling is effective for 2012, enter the date of the ruling

b Check box to indicate whether the foundation is a private operating foundation described in section

2 a Enter the lesser of the adjusted net L Tax year Prior 3 year

Income from Part I or the minimum (a) 2012 (b) 2011 (C) 2010

investment return from Part X for

each year listed

b 85% of line 2a

o Qualifying distributions from Part Xli,

line 4 for each year listed

d Amounts included in line 2c not

used directly for active conduct of

exempt activities

e Qualifying distributions made directly

for active conduct of exempt activities.

Subtract line 2d from line 2c3 Complete 3a, b, or c for the

alternative test relied upon:a 'Assets' afternailve test - enter:

(1) Value of all assets

(2) Value of assets qualifyingunder section 4942(j)(3)(13)(i)

b 'Endowment' alternative test - enter2/3 of minimum investment returnshown in Part X, line 6 for each yearlisted ..........................................

c Support' alternative test - enter

(1) Total support other than grossinvestment income (interest,dividends, rents, payments onsecurities loans (section512(a)(5)), or royalties)

(2) Support from general publicand 5 or more exemptorganizations as provided insection 4942(j)(3)(8)(iil)

(3) Largest amount of support from

an exempt organization

or

(d)2009 I (e)Total

I Part XV I Supplementary Information (Complete this part only if the foundation had $5,000 or more in assetsat any time during the year-see instructions.)

1 Information Regarding Foundation Managers:

a List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation before the close of any taxyear (but only if they have contributed more than $5,000). (See section 507(d)(2).)

NONEb List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the ownership of a partnership or

other entity) of which the foundation has a 10% or greater interest

NONE2 Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:

Check here if the foundation only makes contributions to preselected charitable organizations and does not accept unsolicited requests for funds. Ifthe foundation makes gifts, grants, etc. (see instructions) to individuals or organizations under other conditions, complete items 2a, b, c, and d.

a The name, address, and telephone number or e-mail of the person to whom applications should be addressed:

b The form in which applications should be submitted and information and materials they should include:

c Any submission deadlines:

d Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other factors:

223601 12-05-12

Form 990-PF (2012)

1010531111 737725 BLOOMF.AMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

S

IY FOUNDATI

IV I Up.nJIIwIwIy uiiurtiiaiion (continued) -

nts and Contributions Paid During the Year or Approved for Future PaymentRecipient If recipient is an individual,

show any relationship to Foundation Purpose of grant orName and address (home or business) any foundation manager status of contribution Amount

or substantial contributor recipient

11

a Paid during the year

AMERICA ACHIEVES, INC. - SEE STMT 10

13.769 GAINSBOROUGH ROAD

POTOMAC, MD 20854

ASSOCIATION FOR SAFE INTERNATIONAL

ROAD TRAVEL

11769 GAINSBOROUGH ROAD

CHARITY ISDUCATION REFORM

C CHARITY TO PROMOTE ROAD SAFETY

LOW-MIDDLE INCOME

0

CAMPAIGN FOR TOBACCO FREE KIDS CHARITY ITO REDUCE TOBACCO USE1400 EYE STREET, NW SUITE 1200

CDC FOUNDATION TONE PUBLIC CHARITY rO REDUCE TOBACCO USE8800 AMBASSADOR ROW

DALLAS, TX 75247 5.492.000

NATIONAL FOUNDATION FOR THE CENTERS TONE PUBLIC CHARITY rO REDUCE MATERNALFOR DISEASE CONTROL & PREVENTION DEATHS IN TANZANIA8800 AMBASSADOR ROW

DALLAS, TX 75247 630 865Total SEE ... COT.LNtJATION ... SHEFT.(.S)................................................. Bo . 3a 131.263386

b Approved for future payment

NATIONAL FOUNDATION FOR THE CENTERS TONE PUBLIC CHARITY rO REDUCE MATERNALFOR DISEASE CONTROL & PREVENTION DEATHS IN TANZANIA8800 AMBASSADOR ROW

DALLAS, TX 75247 678,180,

NATIONAL FOUNDATION FOR THE CENTERS TONE PUBLIC CHARITY COLLABORATION WITHFOR DISEASE CONTROL & PREVENTION SATES FOUNDATION TO8800 AMBASSADOR ROW REDUCE TOBACCO USEDALLAS, TX 75247 476.910,

CITY OF ATLANTA ONE LOCALINNOVATION INOFFICE OF THE MAYOR, 55 TRINITY GOVERNMENT ITY GOVERNMENTAVENUE S.W., SUITE 2400 ATLANTA, GA30303 467,000,

Total SEE ... CONTINUATION ... S.HEET.(.S..) ... .............................................. 3b 51661,679.

223611 Form 990—P F (2012)12-05-12


)n b22,

(e)

(d) Related or exemptAmount function Income

(a) (b)Business Amountcode

S SW IV

Form99O-PF (2012) THE BLOOMBERG FAMILY FOUNDATION INC 205602483 Page 12

III!irtXVl-A Analysis of Income-Producing Activities

Enter gross amounts unless otherwise indicated.

1 Program service revenue:

a

b

C

d

e

g Fees and contracts from government agencies

2 Membership dues and assessments

3 Interest on savings and temporary cash

investments............................................................

4 Dividends and interest from securities

5 Net rental income or (loss) from real estate:

a Debt-financed property

b Not debt-financed property

6 Net rental income or (loss) from personal

property...........................................................

7 Other investment income

8 Gain or (loss) from sales of assets other

than inventory

9 Net income or (loss) from special events ......

10 Gross profit or (loss) from sales of inventory

11 Other revenue:

a

b

C

d

14 5,122.

14 47,504,091. 1

3000 <1,644,608.44 3,796,786.

3000 1.119.815. 18155.237.277.

e L12 Subtotal. Add columns (b),(d), and (e) I <524,793.1>. 1 206,543,276. 111,716.13 Total. Add line 12, columns (b), (d), and (e) ...........................................................................13 206,130 ,199.(See worksheet in line 13 instructions to verify calculations.)

Part XVI-Bj Relationship of Activities to the Accomplishment of Exempt Purposes

12-05-12 rurui u-r-r- tzu )12

10531111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FO1JNDA BLOOMFA2

Form 99O-PF(2D12) THE BLOOMEERG FAMILY FOUNDATION INC 20-5602483 Page 13Part XVII I Information Regarding Transfers To and Transactions and Relationships With Noncharitable

Exempt OrganizationsDid the organization directly or indirectly engage in any of the following with any other organization described In section 501(c) of - Yes Nthe Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?

a Transfers from the reporting foundation to a noncharitable exempt organization of

(1) Cash.i_(i) X

(2) Other assets

b Other transactions:

(1) Sales of assets to anoncharitable exempt organization .i1i x(2) Purchases of assets from a noncharitable exempt organization .1 - I(3) Rental of facilities, equipment or other assets .._

(4) Reimbursement arrangements .-

(5) Loans or loan guarantees .-

(6) Performance of services or membership or fundraising solicitations .i

o Sharing of facilities, equipment, mailing lists, other assets, or paid employees .ji - xd If the answer to any of the above is 'Yes," complete the following schedule. Column (b) should always show the fair market value of the goods, other assets,

or services given by the reporting foundation. If the foundation received less than fair market value in any transaction or sharing arrangement, show in

a is me Tounoation aireciiy or Inalrectly atilliatee with, or related to, one or more tax-exempt organizations described

in section 501(c) of the Code (other than section 501(c)(3)) or in section 527? El Yes DO No

Name of a

of organization

Description of

N/A

Under penalties of perjury, I declare that I have examined this return, Including accompanying schedules and statements and to the best of my knowledge

IMay the IRS discuss thIilSign

and belief i

shown below (see nstr.)?SIGNER [ ] Yes E IHere

7taxpayer) is based on aS Infoimatlon of owledga return with the preparer

Iul No

Signature of officer ortustee ______Date TitlePrint/Type preparer's name I Preparer's signature , I Date I Check r'-i if I PuN

Paid CHARLES POMOPreparer Firm's name GELLER & COMPANY LLCUse Only

self- employed

Firm'sElN lo. 13-4149326

Firm's address 110. 909 THIRD AVENUE 16TH FLOOR—z,o'—ouuu

Form 990-PF (2012)

22362212-05-12


FA

Form 8868(Rev. January 2013)Dmrl,nent of the Treasuryinternal Revenue Sevice


File a separate application for each return.

OMB No. 1545-1709

• If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box [J• If you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part Il (on page 2 of this form).

Do not complete Part// unless you have already been granted an automatic 3-month extension on a previously filed Form 8868.Electronic filing (e-file) . You can electronically file Form 8868 if you need a 3-month automatic extension of time to file (6 months for a corporationrequired to file Form 990-1), or an additional (not automatic) 3-month extension of time. You can electronically file Form 8868 to request an extensionof time to file any of the forms listed in Part I or Part II with the exception of Form 8870, Information Return for Transfers Associated With CertainPersonal Benefit Contracts, which must be sent to the IRS in paper format (see instructions). For more details on the electronic filing of this form,visit www.irsgov/efile and click on e-file for Charities & Nonprofits.

I Part I I Automatic 3-Month Extension of Time. Only submit original (no copies needed).A corporation required to file Form 990-T and requesting an automatic 6-month extension - check this box and completePart lonly []All other corporations (including 1120-C fliers), partnerships, REM/Cs, and trusts must use Form 7004 to request an extension of timeto file income tax returns.

Type or

Name of exempt organization or other filer, see instructions. Employer identification number (EIN) orprint

File by thedue date forfiling yourreturn. Seeinstructions.

THE BLOOMBERG FAMILY FOUNDATION INCNumber, street, and room or suite no. If a P.O. box, see instructions.C/O GELLER & CO, 909 THIRD AVE, NO. 16 FLCity, town or post office, state, and ZIP code. For a foreign address, see instructions.NEW YORK, NY 10022


Enter the Return code for the return that this application is for (file a separate application for each return) -T-14

Application Return I Application ReturnIs ForForm 990 or Form 990-EZ

01 Form 990-TForm 990-BL

02 Form 1041

0803 Form 472004 Form 5227

Form 990-T

05 Form 6069

1106 Form 8870

12.1. , ...( '.J nJfl.IJJJJ.aJ.% ¼.',J .UJJ'....

• The booksarein the care of' 909 THIRD AVENUE, 16TH FL - NEW YORK, NY 10022Telephone No. 2125836000 FAXNo- 2125836241

• If the organization does not have an office or place of business in the United States, check this box• If this is for a Group Return, enter the organizations four digit Group Exemption Number (GEN) . IfIf this is for the whole group, check thisbox Oo, [J - If it is for part of the group, check this box and attach a list with the names and ElNs of all members the extension is for.1 I request an automatic 3-month (6 months for a corporation required to file Form 990-1) extension of time until

AUGUST 15, 2013 to file the exempt organization return for the organization named above. The extensionis for the organization's return for:p-IXI calendar year 2Ol2 orOo. El tax year beginning and ending

2 If the tax year entered in line 1 is for less than 12 months, check reason: Initial çetum Final returnChange in accounting period

35 If this application is for Form 990-BL, 990-PF, 990-1, 4720, or 6069, enter the tentative tax, less any

3a $ 2,900,515.b If this application is for Form 990-PF, 990-1,4720, or 6069, enter any refundable credits and

estimated tax payments made. Include any prior year overpayment allowed as a credit. 3,112,153.C Balance due. Subtract line 3b from line 3a. Include your payment with this form, if required,

by using EFTPS (Electronic Federal Tax Payment System). See instructions. I Sc I $ 0Caution. If you are going to make an electronic fund withdrawal with this Form 8868, see Form 8453-E0 and Form 8879-E0 for payment instructions.LI-IA For Privacy Act and Paperwork Reduction Act Notice, see instructions. Form 8868 (Rev. 1-2013)

22384101-21-13

13560509 737725 BLOOMFAMFND 2012.03040 THE BLOO4BERG FAMILY FOUNDA BLOOMFA1

A

—Form 8868 (Rev. 12013) Page 2

• If you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part II and check this box ....................... 1110. LXJNote. Only complete Part II if you have already been granted an automatic 3-month extension on a previously filed Form 8868.

• If you are filing for an Automatic 3-Month Extension, complete only Part I (on page 1).

Part III Additional (Not Automatic) 3-Month Extension of Time.Only file the original (no copies needed).

Type or

print

Re by thedue date for

tiling yourrelian SeeIflSlnJCtIClle.

Name of exempt organization or other filer, see Instructions

BLOOMBERG FAMILY FOUNDATION INCNumber, street, and room or suite no. If a P.O. box, see instructions.

/0 GELLER & CO, 909 THIRD AVE. NO. 16 FLCity, town or post office, state, and ZIP code. For a foreign address, see instructions.EW YORK, NY 10022

Employer identification number (E1N) or


Enter the Return code for the return that this application is for (file a separate application for each return) .................................... [0141

STOP! Do not complete Part II if you were not already granted an automatic 3-month extension on a previously filed Form 8868.

DIANE GUBELLI, C/O GELLER & CO LLC• The books are in the care of 909 THIRD AVENUE, 16TH FL - NEW YORK, NY 10022

TelephoneNo.- 2125836000 FAXNo.- 212-583-6241• if the organization does not have an office or place of business in the United States, check this box ............................................. IX]• If this is for a Group Return, enter the organization's four droup Exemption Number (GEN) ________ - If this is for the whole group, check this

4 I request an additional 3-month extension of time until NOViNb1iK .L D, 4 Ui. i.

5 For calendar year 2 012 , or other tax year beginning and endin

8 If the tax year entered In line 5 is for less than 12 months, check reason: L.J Initial return Final return

EJ Change in accounting period

7 State in detail why you need the extension

AN ADDITIONAL EXTENSION OF TIME IS REQUIRED TO FILE A COMPLETE ANDACCURATE RETURN BECAUSE ALL INFORMATION IS NOT AVAILABLE.

8a if this application is for Form 990-BL 990-PF, 990-1, 4720, or 6069, enter the tentative tax, less any

nonrefundablecredits. SeeInstructions. 8a 1 $ 4,612,153.b If this application is for Form 990-PF, 990-1,4720, or 6069, enter any refundable credits and estimated

tax payments made. Include any prior year overpayment allowed as a credit and any amount paid

previously with Form 8868. 8b $ 4,612,153.c Balance due. Subtract line 8b from line Ba. Include your payment with this form, if required, by using

EFTPS (Electronic Federal Tax Payment System).See Instructions. Sc $ 0.Signature and Verification must be completed for Part II only.

Under penalties of perjury, I declare that I hav.eamined this form, Including accompanying schedules and statements, and to the best of m y knowledgend belief,It is true, correct, an ,tilete, pØ that I Mjt1thorlzejgprepare this form. -7"-/

CPA Date

(Rev. 1-2013)

2234201-21-13


S

.

1TION FOR 990—PF, PART IV

C

d

:apjtal Gains and Losses for Tax on Investment Income

(a) List and describe the kind(s) of property sold, e.g., real estate,

2-story brick warehouse; or common stock, 200 she. MLC Co.

K—i - WILLETT PRIVATE INVESTORS (ATED BUSINESS GAIN REPORTED ON FOK—i - WILLETT SELECT INVESTORS (T0.000 UST .5% DUE 11/30/12

(c Date acquired (d) Date sold(mo., day, yr.) (ma., day, yr.)

8/1

(e) Gross sales price(f) Depreciation allowed

(or allowable)(g) Cost or other basisplus expense of sale

nUU

(h) Gain or (loss)(e) plus (1) minus (g)

516.815.576.

0.ef

n

0

Complete only for assets sh

(I) F.M.V. as of 12/31/69

gain in column (h) and owned by the foundation on 12131/69

(j) Adjusted basis (k) Excess of col. (i)as of 12/31/69 1 over coL(j), if any

(I) Losses (from col. (h))Gains (excess of col. (h) gain over col. (k),

but not less than '-0-')

6

If gain, also enter in Part I, line 7 I I2 Capital gain net income or (net capital loss) ......(If (loss), enter'-O-" in Part I, line 7 ) ..................I 2 155,237,2773 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):

}3 N/AIf gain, also enter in Part I, line 8, column (c).If (loss), enter '-0-' in Part I, line 8

22359105-01-12


Purpose of grant orcontribution

BORATION WITH

FOUNDATION TO

E TOBACCO USE

INNOVATION IN

GOVERNMENT

Amount

I20-56024

I Part XV I Supplementary Information

3 Grants and Contributions Paid During the Year (Continuation)

Recipient If recipient is an individual,show any relationship to Foundation

Name and address (home or business) anyflmbar recipientor substantial

NATIONAL FOUNDATION FOR THE CENTERS TONE ?UBLIC CHARITYFOR DISEASE CONTROL & PREVENTION

8800 AMBASSADOR ROW

DALLAS, TX 75247

CITY OF ATLANTAlONE OCALOFFICE OF THE MAYOR S 55 TRINITY OVERNMENTAVENUE S.W.. SUITE 2400 ATLANTA GA

CITY OF CHICAGO

121 N LASALLE STREET. ROOM 507

CITY OF LOUISVILLE

527 WEST JEFFERSON STREET

CAMPAIGN FOR TOBACCO FREE KIDS

1400 EYE STREET, NW SUITE 1200

CITY OF MEMPHIS

125 N MAIN STREET 7TH FLOOR

EL PODER DEL CONSUMIDOR, A.C.

JUAREZ 67-4, COL. SANTA URSULA COAPA

C.P. 04650, MEXICO D.F.. MEXICO

EMBARQ - THE WRI CENTER FOR

SUSTAINABLE TRANSPORT

10 C STREET NE #800

WASHINGTON, DC 20002

ENVIRONMENTAL DEFENSE FUND

257 PARK AVENUE SOUTH, 17TH FL

NEW YORK, NY 10010

FUND FOR CITIES OF SERVICE, INC.

909 THIRD AVENUE. 16TH FL

FUND INNOVATION IN

lENT CITY GOVERNMENT

'UN]) INNOVATION INlENT CITY GOVERNMENT

CHARITY COLLABORATION WITH

GATES FOUNDATION TO

REDUCE TOBACCO USE

FUND INNOVATION INlENT CITY GOVERNMENT

F NON TO COMBAT OBESITY IN

MEXICO

CHARITY rO PROMOTE ROAD SAFETY

N LOW-MIDDLE INCOME

COUNTRIES

CHARITY 0 MINIMIZE THE IMPACT

HE EXTRACTION OF

NATURAL GAS HAS ON THE

ENVIRONMENT

CHARITY ROMOTE VOLUNTEERISM

N CITIES

22363105-01-12

1510531111 737725 BLOOMFANFND 2012.04040 THE BLOOMBERG FAMILY FOUDA BLOOMFA2

S Ii


Recipient IF recipient is an individual,show any relationship to Foundation

Name and address (home or business) any foundation manager status ofor substantial contributor recipient

INSTITUTO NACIONAL DE SALUD PUBLICATONE ?OREIGN NON

UNIVERSIDAD# 655 COLONIA SANTA MARIA XEMPT

AMUACATITLAN CP. 62100 CUERNAVACA

Purpose of grantorcontribution

Amount

COMBAT OBESITY IN

5

INTERNATIONAL BANK FOR RECONSTRUCTION

AND DEVELOPMENT

1818 H STREET, NW

WASHINGTON. DC 20433

INTERNATIONAL FEDERATION OF THE RED

CROSS AND RED CRESCENT SOCIETIES

17 CHEMIN DES CRETS, CH-1211

GENEVA, SWITZERLAND 12

INTERNATIONAL ONION AGAINST

TUBERCULOSIS AND LUNG DISEASE INC.

61 BROADWAY

NEW YORK, NY 10006

JOHN HOPKINS BLOOMBERG SCHOOL OF

PUBLIC HEALTH

615 N. WOLFE STREET

BALTIMORE. MD 21205


PUBLIC HEALTH

615 N. WOLFE STREET

BALTIMORE, MD 21205


PUBLIC HEALTH

615 N. WOLFE STREET

BALTIMORE, MD 21205

LIVING CITIES

1040 AVENUE OF THE AMERICAS, 17TH

FLOOR NEW YORK, NY 10018-3703

MDRC

16 EAST 34TH STREET 19TH FL

MDRC

16 EAST 34TH STREET 19TH FL.

PROMOTE ROAD SAFETY

LOW-MIDDLE INCOME

PROMOTE ROAD SAFETY

LOW-MIDDLE INCOME

CHAR COUNTRIES

CHARITY TO COMBAT OBESITY IN

CHARITY rO PROMOTE ROAD SAFETY

IN LOW-MIDDLE INCOME

OUNTRIES

CHARITY rO REDUCE TOBACCO USE

CHARITY DROWNING PREVENTION

CHARITY SUPPORT THE

LEPLICATION OF

FINANCIAL EMPOWERMENT

ENTERS IN CITIES

CROSS THE US

CHARITY rO IMPROVE OUTCOMES

OR BLACK AND HISPANIC

YOUTH

CHARITY '0 IMPROVE OUTCOMES

OR BLACK AND HISPANIC

22363105-01-12


61^ I

ocon I


Recipient If recipient is an individual,show any relationship to Foundation Purpose of grant or

Name and address (home or business) any foundation manager status of contributionor substantial contributor recipient

NEW YORK UNIVERSITY ONE'UBLIC CHARITY UPPORT INNOVATION IN295 LAFAYETTE STREET, 2ND FLOOR J.S, CITIES

NONPROFIT FINANCE FUND CHARITY SUPPORT ART PROGRAMS70 WEST 36TH STREET. 11TH FL

kIED TO ECONOMIC

THE PEW CHARITABLE TRUSTS CHARITYREATE MARINE901 E STREET, N.W. PROTECTED AREAS

THE ASPEN INSTITUTE INC. CHARITY 9UPPORT EDUCATION ANDONE DUPONT CIRCLE NW SUITE 700 EMPLOYMENT OF AT-RISK

Amount

CITY OF NEW ORLEANS

1300 PERDIDO STREET, SUITE 2E04NEW ORLEANS. LA 70122

MAYOR'S FUND TO ADVANCE NEW YORK CITY

253 BROADWAY, 8TH FLOOR

NEW YORK, NY 10007



NEW YORK, NY 10007



NEW YORK, NY 10007

THE SIERRA CLUB FOUNDATION

85 2ND STREET, 2ND FLOOR

SAN FRANCISCO, CA 94105-3456

FUND INNOVATION INLENT CITY GOVERNMENT

CHARITY ro SUPPORT THE YOUNG

[EN'S INITIATIVE TO

IMPROVE OUTCOMES FOR

YOUTH (BEATING THEDOS)

CHARITY rO SUPPORT THE YOUNG

LENS INITIATIVE TO

IMPROVE OUTCOMES FOR'CUTE (ARCHES)

CHARITY ro SUPPORT THE YOUNG

EN'S INITIATIVE TO

IMPROVE OUTCOMES FOR

YOUTH (VIOLENCE INTER

FROG)

CHARITY ENCOURAGE THE USE OF

LEAN ENERGY AND THEEDUCTION OF COAL

ri

THE WORLD HEALTH ORGANIZATION PROMOTE ROAD SAFETYCH - 1211 LOW-MIDDLE INCOME

22363105-01-12

1710531111 737725 BLOQMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

S


Recipient If recipient is an individual,show any relationship to Foundation

Name and address (home or business) any foundation manager status ofor substantial contributor recipient

THE WORLD HEALTH ORGANIZATION

CH - 1211

GENEVA SWITZERLAND

WOMEN FOR WOMEN INTERNATIONAL

CHARITY

4455 CONNECTICUT AVENUE, NW, SUITE 200

WASHINGTON, DC 20008

S20-5602483

Purpose of grant orcontribution Amount

OWNING PREVENTION

177

.EATE ECONOMIC

?PORTUNITY FOR WOMEN

POST-CONFLICT

WORLD LUNG FOUNDATION

CHARITY TO REDUCE MATERNAL

61 BROADWAY - 6TH FL

DEATHS IN TANZANIA


CHARITY fiO PROMOTE ROAD SAFETY


IN LOW-MIDDLE INCOME


CHARITY frO REDUCE TOBACCO USE


WORLD LUNG FOUNDATION - SEE STMT 10

CHARITY pOLLABORA'rIoN WITH


bATES FOUNDATION TO

EARMARKED GRANTS - SEE STATEMENT 10

22303105-01-12


PC

n3 Grants and Contributions Approved for Future Payment (Continuation)

Recipient If recipient is an individual,show any relationship to Foundation Purpose of grantor


CITY OF CHICAGO NONE OCAL FUND INNOVATION IN

121 N LASALLE STREET, ROOM 507 4OVERNMENT 2ITY GOVERNMENT

CHICAGO. IL 60602

CITY OF LOUISVILLE ONE LOCAL FUND INNOVATION IN

527 WEST JEFFERSON STREET GOVERNMENT CITY GOVERNMENT

LOUISVILLE, KY 40202

CITY OF MEMPHIS NONE LOCAL FUND INNOVATION IN

125 N MAIN STREET, 7TH FLOOR GOVERNMENT CITY GOVERNMENT

MEMPHIS, TN 38103

ENVIRONMENTAL DEFENSE FUND 90NE PUBLIC CHARITY TO MINIMIZE THE IMPACT

257 PARK AVENUE SOUTH, 17TH FL rHE EXTRACTION OF

NEW YORK, NY 10010 NATURAL GAS HAS ON THE

ENVIRONMENT

FUND FOR CITIES OF SERVICE, INC. 90NE PUBLIC CHARITY PROMOTE VOLUNTEERISM

909 THIRD AVENUE, 16TH FL IN CITIES

NEW YORK, NY 10022

JOHN HOPKINS BLOOMBERG SCHOOL OF NONE PUBLIC CHARITY DROWNING PREVENTION

PUBLIC HEALTH

615 N. WOLFE STREET

BALTIMORE. ND 21205

LIVING CITIES NONE PUBLIC CHARITY SUPPORT THE

1040 AVENUE OF THE AMERICAS, 17TH REPLICATION OF

FLOOR NEW YORK, NY 10018-3703 FINANCIAL EMPOWERMENT

ENTERS IN CITIES

CROSS THE US

MAYOR'S FUND TO ADVANCE NEW YORK CITY NONE PUBLIC CHARITY 10 SUPPORT THE YOUNG

253 BROADWAY, 8TH FLOOR EN'S INITIATIVE TO

NEW YORK, NY 10007 IMPROVE OUTCOMES FOR

YOUTH (ARCHES)

NDRC NONE PUBLIC CHARITY rO IMPROVE OUTCOMES

16 EAST 34TH STREET, 19TH FL FOR BLACK AND HISPANIC

NEW YORK, NY 10016 YOUTH

NDRCPUBLIC CHARITY TO IMPROVE OUTCOMESTONE

16 EAST 34TH STREET. 19TH FL OR BLACK AND HISPANIC

22363505-01-12

1910531111 737725 ELOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

Amount

0

0

S

.

3 Grants and Contributions Approved for Future Payment (Continuation)

Recipient If recipient is an individual,show any relationship to Foundation Purpose of grant or


THE PEW CHARITABLE TRUSTS TONE 'UBLIC CHARITYREATE MARINE901 8 STREET, N.W. ^ROTECTED AREAS

THE ASPEN INSTITUTE INC. CHARITY

EDUCATION ANDONE DUPONT CIRCLE, NW, SUITE 700 NT OF AT-RISK

Amount

CITY OF NEW ORLEANS

INNOVATION IN1300 PERDIDO STREET, SUITE 2EO4

GOVERNMENT

NEW ORLEANS, LA 70122

THE SIERRA CLUB FOUNDATION CHARITY

RAGE THE USE OF85 2ND STREET, 2ND FLOOR

ENERGY AND THE

SAN FRANCISCO, CA 94105-3456 TION OF COAL

THE WORLD HEALTH ORGANIZATION PREVENTIONCH - 1211


C CHARITY TO REDUCE MATERNAL61 BROADWAY - 6TH FL EATHS IN TANZANIA


CHARITY FOLLABORATION WITH61 BROADWAY - GTE FL 2ATES FOUNDATION TO

EARMARKED GRANTS - SEE STATEMENT 10

22383505-01-12


I ITHE BLOOMBERG FAMILY PDATION INC

LAI

20-5602483

FORM 990-PF INTEREST ON SAVINGS AND TEMPORARY CASH INVESTMENTS STATEMENT 2

SOURCE AMOUNT

BANK OF AMERICA AGERUP MATERNAL HEALTH ACCOUNT 203.BANK OF AMERICA GATES FOUNDATION TOBACCO CONTROL 4,919.

TOTAL TO FORM 990-PF, PART I, LINE 3, COLUMN A 5,122.

FORM 990-PF DIVIDENDS AND INTEREST FROM SECURITIES STATEMENT 3

SOURCE

FROM K-i - WILLETT PRIVATEINVESTORS (TAX EXEMPT) I ILCFROM K-i - WILLETT PRIVATEINVESTORS (TAX EXEMPT) I LLCFROM K-i - WILLETT SELECTINVESTORS (TAX EXEMPT) I LPFROM K-i - WILLETT SELECTINVESTORS (TAX EXEMPT) I LPUS TRUSTUST BILLSVANGUARDVANGUARD AMORTIZATION

CAPITAL GAINSGROSS AMOUNT DIVIDENDS

9,031,465. 0.

4,056,735. 0.

10,366,695. 0.

24,130,295. 0.

414. 0.

7,215. 0.

67,673. 0.

<44,685.> 0.

COLUMN (A)AMOUNT

9,031,465.

4,056,735.

10,366,695.

24,130,295.414.

7,215.67,673.

<44,685.>

TOTAL TO FM 990-PF, PART I, LN 4 47,615,807. 0. 47,615,807.

FORM 990-PF OTHER INCOME STATEMENT 4

DESCRIPTION

FROM K-i - WILLETT PRIVATEINVESTORS (TAX EXEMPT) I LLCUNRELATED BUSINESS TAXABLE LOSSREPORTED ON FORM 990-TFROM K-i - WILLETT SELECT INVESTORS(TAX EXEMPT) I LPUNRELATED BUSINESS TAXABLE INCOMEREPORTED ON FORM 990-T

(A) (B)REVENUE NET INVEST-PER BOOKS MENT INCOME

646,582. 646,582.

<2,007,762.> 0.

3,150,204. 3,150,204.

363,154. AF

(C)ADJUSTEDNET INCOME

TOTAL TO FORM 990-PF, PART I, LINE 11 2,152,178. 3,796,786.

21 STATEMENT(S) 2, 3, 410531111 737725 BLOOMFANFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

0THE BLOOMBERG FAMILY P JATION INC C 20-5602483

FORM 990-PF LEGAL FEES STATEMENT 5

(A)

(B)

(C) (D)EXPENSES NET INVEST-

ADJUSTED CHARITABLEDESCRIPTION

PER BOOKS MENT INCOME NET INCOME PURPOSES

WILLKIE FARR & GALLAGHERLLP

357,526. 0. 357,526.OTHER LEGAL FEES

259. 0. 259.

TO FM 990-PF, PG 1, LN 16A 357,785. 0. 357,785.

FORM 990-PF ACCOUNTING FEES STATEMENT 6

(A) (B)EXPENSES NET INVEST-

DESCRIPTION PER BOOKS MENT INCOME

GELLER & CO 474,903. 237,452.MITCHELL & TITUS, LLP 20,000. 0.KPMG, LLP 40,000. 0.ERNST & YOUNG 2,500. 0.

TO FORM 990-PF, PG 1, LN 16B 537,403. 237,452.

(C) (D)ADJUSTED CHARITABLE

NET INCOME PURPOSES

237,451.0.0.0.

237,451.

FORM 990-PP OTHER PROFESSIONAL FEES STATEMENT 7

(A) (B) (C)

(D)EXPENSES NET INVEST- ADJUSTED

CHARITABLEDESCRIPTION

PER BOOKS MENT INCOME NET INCOME

PURPOSES

OTHER PROFESSIONAL FEES

12,000. 0.

TO FORM 990-PF, PG 1, LN 16C

12,000. 0.

22 STATEMENT(S) 5, 6, 710531111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

(A)

(B)

(C)

(D)EXPENSES NET INVEST- ADJUSTED

CHARITABLEPER BOOKS MENT INCOME NET INCOME PURPOSES

2,100,000. 0. 0.

16,800. 16,800.

460,907.66,047.

6,278.45.

460,907.0. 19

of2,650,077. 477,707. 0.

THE BLOOMBERG FAMILY FDATION INC V 20-5602483

FORM 990—PF TAXES STATEMENT 8

DESCRIPTION

FEDERAL EXCISE TAXFOREIGN TAX WITHHELD:FROMK—i - WILLETT PRIVATEINVESTORS (TAX EXEMPT) IFOREIGN TAX WITHHELD:FROMK—i - WILLETT SELECTINVESTORS (TAX EXEMPT) IUNRELATED BUSINESS TAXUBT - INTEREST ANDPENALTIESBACKUP WITHHOLDING

TO FORM 990—PF, PG 1, LN 18

FORM 990—PF OTHER EXPENSES STATEMENT 9

(A)EXPENSESPER BOOKS

3,508.1,406.

DESCRIPTION

BANK FEESFILING FEESINSURANCE - PROFESSIONALLIABILITYNON—DEDUCTIBLE EXPENSESOTHER DEDUCTIONS - FROM K—i- WILLETT PRIVATE INVESTORS(TAX EXEMPT) I LLCOTHER DEDUCTIONS - FROM K—i- WILLETT SELECT INVESTORS(TAX EXEMPT) I LP

TO FORM 990—PF, PG 1, LN 23

(B)

(C) (D)NET INVEST-

ADJUSTED CHARITABLEMENT INCOME NET INCOME PURPOSES

1,754. 1,754.

0. 1,406.

116,080. 58,040.

37,664. 0.

14,046,604. 14,046,604. ME

17,640,437. 17,640,437. 0.

31,845,699. 31,688,795. 61,200.

FOOTNOTES STATEMENT 10

PART VIII: LINE 1 COLUMN (B)

THE DIRECTORS WHO ARE LISTED AT .58 HOURS PER WEEKSPEND APPROXIMATELY 30 HOURS PER YEAR ON FOUNDATIONRELATED MATTERS.

23 STATEMENT(S) 8, 9, 1010531111 737725 BLOOMFANFND 2012.04040 THE BLOOMBERG FAMILY FOTJNDA BLOOMFA2

THE BLOOMBERG FAMILY FDATION INC 20-5602483

PART XIII - UNDISTRIBUTED INCOME, LINE 4C AND LINE 7

SECTION 4942(H)(2) ELECTIONAS TO THE TREATMENT OF QUALIFYING DISTRIBUTIONS

PURSUANT TO IRC SEC. 4942(H)(2) AND REG. 53.4942(A)-3(D)(2),THE BLOOMBERG FAMILY FOUNDATION INC. HEREBY ELECTS TO TREAT$6,752,845 OF TOTAL CURRENT YEAR QUALIFYING DISTRIBUTIONS INEXCESS OF THE IMMEDIATELY PRECEDING TAX YEAR'S UNDISTRIBUTEDINCOME AS BEING MADE OUT OF CORPUS.

SIGNED:

NAME AND TITLE: MICHAEL R. BLOOMBERG, AUTHORIZED SIGNER

24 STATEMENT(S) 1010531111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

I ITHE BLOOMBERG FAMILY Ft6ATION INC

20-5602483

PART XV - SUPPLEMENTARY INFORMATION

LINE 3A - GRANTS AND CONTRIBUTIONS PAID DURING THE YEARTHE FOLLOWING ORGANIZATIONS ARE SUB-GRANTEES OF AMERICAACHIEVES, INC.:

THOMAS B. FORDHAM INSTITUTE - IRC 501(C)(3) PUBLIC CHARITYANALYSIS OF METHODS TO IMPROVE HOW SCHOOL SYSTEMS SELECTNEW PRINCIPALS

NEW LEADERS D/B/A NEW LEADERS FOR NEW SCHOOLS -IRC 501(C)(3) PUBLIC CHARITY(1) - STATE SUPERINTENDENTS FELLOWSHIP GRANTS(2) - PRINCIPAL VIDEO TIED TO PRINCIPAL EVALUATIONS(3) - SUPPORT DEVELOPMENT OF TOOL TO MEASURE AND IMPROVEPERFORMANCE OF SITTING PRINCIPALS

THE EDUCATION TRUST - IRC 501(C) (3) PUBLIC CHARITYIDENTIFYING MISSING DATA NEEDED TO EQUIP STATE AND LOCALPOLl CYMAKERS

NEW SCHOOLS FUND - IRC 501(C)(3) PUBLIC CHARITYSPONSOR SESSION ON INTERNATIONAL BENCHMARKING IN NATION'SLEADING EDUCATION REFORM SUIT

THE ORGANISATION FOR ECONOMIC COOPERATION AND DEVELOPMENT(OECD) - INTERNATIONAL ORGANIZATION DESIGNATED BY EXECUTIVEORDER UNDER 22 U.S.C. SECTION 288 (EX. ORD. NO. 10133, JUNE27, 1950, 15 F.R. 4159)DEVELOPMENT OF ADDITIONAL ANALYSES AND COMPLETION OF PUBLICREPORT

50,000.

602,000.

40,000.

50,000.

140,000.


THE BLOOMBERG FAMILY ECDATION INC 20-5602483


LINE 3A - GRANTS AND CONTRIBUTIONS PAID DURING THE YEARTHE FOLLOWING ORGANIZATIONS ARE SUB-GRANTEES OF EDUCATIONCHAMPIONS FOR ALL, INC. D/B/A AMERICA ACHIEVES, INC.:

THE ORGANISATION FOR ECONOMIC COOPERATION AND DEVELOPMENT(OECD.) - INTERNATIONAL ORGANIZATION DESIGNATED BY EXECUTIVEORDER UNDER 22 U.S.C. SECTION 288 (EX. ORD. NO. 10133, JUNE27, 1950, 15 F.R. 4159)SUPPORT THE DEVELOPMENT AND ADMINISTRATION OF THE PISA-BASEDTEST FOR SCHOOLS 200,000.

ACHIEVE INC. - IRC 501(C)(3) PUBLIC CHARITYSUPPORT A JANUARY 2012 CONVENING TO EXPLORE REQUESTS FROMSTATES FOR ASSISTANCE AROUND DEVELOPING TOOLS AND PROCESSESFOR IDENTIFYING THE QUALITY OF INSTRUCTIONAL MATERIALSALIGNED TO THE COMMON CORE STATE STANDARDS

THE ASPEN INSTITUTE INC. - IRC 501(C)(3) PUBLIC CHARITYSUPPORT WORK IN THE AREA OF SCHOOL LEADERSHIP

NEW LEADERS D/B/A NEW LEADERS FOR NEW SCHOOLS -IRC 501(C)(3) PUBLIC CHARITY(1) - SUPPORT EFFECTIVE PRACTICE INCENTIVE PROGRAM(2) - SUPPORT THE STATE SERVICES PROJECT IN CONNECTICUT,INDIANA AND TENNESSEE(3) - SUPPORT WORK IN THE AREA OF SCHOOL LEADERSHIP

THIRD SECTOR NEW ENGLAND, INC. - IRC 501(C)(3) PUBLICCHARITYSUPPORT KINDERGARTEN ENTRY ASSESSMENT WORK, INCLUDINGRESEARCH AND THE PLANNING OF CROSS-STATE CONVENINGS

50,000.

500,000.

850,000.

100,000.

26 STATEMENT(S) 1010531111 737725 BLOOMFANFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

THE BLOOMBERG FAMILY FATION INC 20-5602483


LINE 3A - GRANTS AND CONTRIBUTIONS PAID DURING THE YEARTHE FOLLOWING ORGANIZATIONS ARE SUB-GRANTEES OF THE WORLDLUNG FOUNDATION:

INTERNATIONAL UNION AGAINST TUBERCULOSIS AND LUNG DISEASEINC. - IRC 501(C)(3) PUBLIC CHARITYSUPPORT ADMINISTRATION OF A PILOT COMPETITIVE GRANTS PROGRAMFOCUSING ON ESTABLISHING SMOKE FREE ENVIRONMENTS 1,000,000.

27 STATEMENT(S) 1010531111 737725 BLOOMF.AMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

THE BLOOMBERG FAMILY FATION INC 20-5602483


LINE 3A - GRANTS AND CONTRIBUTIONS PAID DURING THE YEAR

THE FOLLOWING ORGANIZATIONS ARE EARMARKED SUB-GRANTEES FROMTHE GATES FOUNDATION:

NATIONAL FOUNDATION FOR THE CENTERS FOR DISEASE CONTROL &PREVENTION


TOTAL EARMARKED GRANTS PAID FROM THE GATES FOUNDATION

THE FOLLOWING ORGANIZATIONS ARE EARMARKED SUB-GRANTEES FORH&B AGERUP FOUNDATION:



TOTAL EARMARKED GRANTS PAID FROM H&B AGERUP FOUNDATION

2,212,217.6,291,000.

8,503,217.

163,070.1,216,090.

1,379,160.

TOTAL EARMARKED GRANTS PAID 9,882,377.


E

.

THE BLOOMBERO FAMILY PIWATION INC

LAI

20-5602483


LINE 3B - GRANTS AND CONTRIBUTIONS APPROVED FOR FUTUREPAYMENT

THE FOLLOWING ORGANIZATIONS ARE EARMARKED SUB-GRANTEES FROMTHE GATES FOUNDATION:



TOTAL EARMARKED GRANTS APPROVED FROM THE GATES FOUNDATION

493,680.2,000,000.

2,493,680.

THE FOLLOWING ORGANIZATIONS ARE EARMARKED SUB-GRANTEES FORPREVENTION

H&B AGERUP FOUNDATION:



TOTAL EARMARKED GRANTS APPROVED FROM H&B AGERUP FOUNDATION

236,930.

1,929,388.

2,166,318.

TOTAL EARMARKED GRANTS APPROVED FOR FUTURE PAYMENT

4,659,998.


.

THE BLOONBERG FAMILY FDATION INC

PART I: LINE GA COLUMN (A) AND LINE 6B

%-4

20-5602483

GROSS SALES PRICE FOR ALL ASSETS ON LINE 6A AS REPORTED ONLINE 6B OF $13,300,000 INCLUDES ONLY DIRECT SALES OF ASSETSOWNED BY THE BLOOMBERG FAMILY FOUNDATION INC. NET GAIN FROMSALES ON ASSETS OF $156,357,092 AS REPORTED ON LINE GACOLUMN (A) INCLUDES PASS THRU GAINS AS FOLLOWS:

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLCWILLETT SELECT INVESTORS (TAX EXEMPT) I LP

TOTAL REPORTED ON LINE GA COLUMN (A)

SINCE THE PASS THRU ENTITIES DO NOT REPORT ALLOCABLE SALESPROCEEDS, LINE 6B DOES NOT INCLUDE ANY ALLOCABLE SHARE OFGROSS PROCEEDS FROM THE SALES THAT GENERATED FLOW THRU GAINSREPORTED ON LINE 6A.

15,046,516.141,310,576.

156,357,092.


DESCRIPTION

VANGUARD T-BILLS

U.S. OTHERGOV'T GOV'T

X

FAIR MARKETBOOK VALUE VALUE

['P


FORM 990-PF U.S. AND STATE/CITY GOVERNMENT OBLIGATIONS STATEMENT 11

TOTAL U. S. GOVERNMENT OBLIGATIONS

TOTAL STATE AND MUNICIPAL GOVERNMENT OBLIGATIONS

TOTAL TO FORM 990-PF, PART II, LINE 10A 0. 0.

FORM 990-PF OTHER INVESTMENTS STATEMENT 12

DESCRIPTIONVALUATIONMETHOD BOOK VALUE

FAIR MARKETVALUE

WILLETT SELECT INVESTORS (TAXEXEMPT) I LPWILLETT PRIVATE INVESTORS (TAXEXEMPT) I LLC

TOTAL TO FORM 990-PF, PART II, LINE 13

COST3,157,127,509. 3,316,694,673.

COST785,738,332. 876,463,424.

3,942,865,841. 4,193,158,097.

31 STATEMENT(s) 11, 1210531111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

.

THE BLOOMBERG FAMILY FWATION INC

20-5602483

FORM 990-?F TRANSFERS TO CONTROLLED ENTITIES STATEMENT 13PART Vu-A, LINE 11

NAME OF CONTROLLED ENTITY

WIL,LETT SELECT INVESTORS (TAX-EXEMPT) I LP

ADDRESS

C/O WILLETT ADVISORS LLC, 25 E 78TH STREETNEW YORK, NY 10075

DESCRIPTION OF TRANSFER

CAPITAL CONTRIBUTIONS

EMPLOYER ID NO

26-1634308

AMOUNTOF TRANSFER

991,919,351.


WILLETT PRIVATE INVESTORS (TAX-EXEMPT) I LLC

ADDRESS



CAPITAL CONTRIBUTIONS

EMPLOYER ID NO

26-2359838

AMOUNTOF TRANSFER

494,000,000.


I is

THE BLOONBERG FAMILY FDATION INC

20-5602483


WILIJETT SELECT INVESTORS II LP

ADDRESS


EMPLOYER ID NO

83-0501786


CAPITAL CONTRIBUTION THROUGH WILLETT SELECT INVESTORS (TAX-EXEMPT) I LP

AMOUNTOF TRANSFER

324,941,009.


WILL,ETT PRIVATE INVESTORS (TAX-EXEMPT) II LP

ADDRESS


EMPLOYER ID NO

98-0678785


CAPITAL CONTRIBUTION THROUGH WILLETT PRIVATE INVESTORS (TAX-EXEMPT) I LLC

AMOUNTOF TRANSFER

108,501,207.


THE BLOOMBERG FAMILY F]DATION INC 20-5602483


EMPLOYER ID NO

031612 INVESTMENT HOLDINGS LLC

80-0793225

ADDRESS



CAPITAL CONTRIBUTION THROUGH WILLETT PRIVATE INVESTORS (TAX-EXEMPT) I, LLC

AMOUNTOF TRANSFER

5,719,612.



ADDRESS



EMPLOYER ID NO

80-0819344

CAPITAL CONTRIBUTION THROUGH WILLETT PRIVATE INVESTORS (TAX-EXEMPT) II LP

AMOUNTOF TRANSFER

11,848,760.


.

THE BLOOMBERG FAMILY FWTION INC

20-5602483



ADDRESS


EMPLOYER ID NO

80-0841232



AMOUNTOF TRANSFER

20,000 ,000.



ADDRESS



EMPLOYER ID NO

46-0751709


AMOUNTOF TRANSFER

22,000,000.

35 STATEMENT(S) 1310531111 737725 BLOOMFANFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOONFA2

I ITHE BLOONBERG FAMILY FCDATION INC

20-5602483



ADDRESS

C/O WIrJLETT ADVISORS LLC, 25 E 78TH STREETNEW YORK, NY 10075


EMPLOYER ID NO

46-0765422


AMOUNTOF TRANSFER

9,900,000.



ADDRESS



EMPLOYER ID NO

46-0775441


AMOUNTOF TRANSFER

18,109,286.


.

THE BLOOMBERG FAMILY FIATION INC

20-5602483



ADDRESS



EMPLOYER ID NO

45-5507007


AMOUNTOF TRANSFER

22,209,537.



ADDRESS



EMPLOYER ID NO

46-1000457


AMOUNTOF TRANSFER

13,431,649.




EMPLOYER ID NO

21813 INVESTMENT HOLDINGS LLC 46-1571879

ADDRESS

C/O WILLETT ADVISORS IJLC, 25 E 78TH STREETNEW YORK, NY 10075


CAPITAL CONTRIBUTION THROUGH WIL1LETT PRIVATE INVESTORS (TAX-EXEMPT) I, LLC

AMOUNTOF TRANSFER

15,000,000.



ADDRESS



EMPLOYER ID NO

46-1030450


AMOUNTOF TRANSFER

25,000,000.

38 STATEMENT(S) 1310531111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOtJNDA BLOOMFA2

THE BLOOMBERG FAMILY FWATION INC 20-5602483


EMPLOYER ID NO

WILLETT (AIV) SELECT INVESTORS I LP 26-1633115

ADDRESS

C/O Wfl,LETT ADVISORS LLC, 25 E 78TH STREETNEW YORK, NY 10075


CAPITAL CONTRIBUTION THROUGH WILLETT SELECT INVESTORS (TAX-EXEMPT) I, LP

AMOUNTOF TRANSFER

91,127,451.

TOTAL AMOUNT OF TRANSFERS TO CONTROLLED ENTITIES 2,173,707,862.


THE BLOOMBERG FAMILY FDATION INC V 20-5602483

FORM 990-PF TRANSFERS FROM CONTROLLED ENTITIES STATEMENT 14PART Vu-A, LINE 11


WILLETT SELECT INVESTORS (TAX-EXEMPT) I LP

ADDRESS



CAPITAL WITHDRAWALS

EMPLOYER ID NO

26-1634308

AMOUNTOF TRANSFER

632,000 , 000.



ADDRESS



EMPLOYER ID NO

80-0793225

CAPITAL WITHDRAWAL THROUGH WILLETT PRIVATE INVESTORS (TAX-EXEMPT) I, LLC

AMOUNTOF TRANSFER

176,760.


THE BLOOMBERG FAMILY NDATION INC 20-5602483


EMPLOYER ID NO

WILLETT (AIV) SELECT INVESTORS I LP 26-1633115

ADDRESS



CAPITAL WITHDRAWAL THROUGH WILLETT SELECT INVESTORS (TAX-EXEMPT) I, LP

AMOUNTOF TRANSFER

226,918,161.

TOTAL AMOUNT OF TRANSFERS FROM CONTROLLED ENTITIES 859,094,921.


THE BLOOMBERG FAMILY PNDATION INC 20-5602483

FORM 990-PF LIST OF CONTROLLED ENTITIES STATEMENT 15PART Vu-A, LINE 11



ADDRESS

C/O WIL,LETT ADVISORS LLC, 25 E 78TH STREETNEW YORK, NY 10075

EMPLOYER ID NO

26-1634308


WILIJETT PRIVATE INVESTORS (TAX-EXEMPT) I LLC

ADDRESS


EMPLOYER ID NO

26-2359838



ADDRESS


EMPLOYER ID NO

26-1634308


WILLETT SELECT INVESTORS II LP

ADDRESS


EMPLOYER ID NO

83-0501786

42 STATEMENT(S) 1510531111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOtJI'IDA BLOOMFA2

4THE BLOOMBERG FAMILY FDATI0N INC 20-5602483


WIL1IETT PRIVATE INVESTORS (TAX-EXEMPT) II LP

ADDRESS

C/a WILLETT ADVISORS LLC, 25 E 78TH STREETNEW YORK, NY 10075

EMPLOYER ID NO

98-0678785



ADDRESS


EMPLOYER ID NO

80-0793225



ADDRESS


EMPLOYER ID NO

80-0793225



ADDRESS


EMPLOYER ID NO

80-0819344



ADDRESS


EMPLOYER ID NO

80-0841232

43 STATEMENT(S) 1510531111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOTJNDA BLOOMFA2

THE BLOOMBERG FAMILY FNDATION INC C 20-5602483

EMPLOYER ID NO

46-0751709



ADDRESS


EMPLOYER ID NO

46-0765422



ADDRESS




ADDRESS


EMPLOYER ID NO

45-3943441

EMPLOYER ID NO

46-0775441



ADDRESS




ADDRESS


EMPLOYER ID NO

45-4001606

44 STATEMENT(S) 1510531111 737725 BLOOMFANFND 2012.04040 THE BLOOMBERG FAMILY FOtINDA BLOOMFA2

.

THE BLOONBERG FAMILY k"'ADATION INC %A

20-5602483



ADDRESS


EMPLOYER ID NO

45-5507007



ADDRESS


EMPLOYER ID NO

46-1000457



ADDRESS

C/O WILLETT ADVISORS IjLC, 25 E 78TH STREETNEW YORK, NY 10075

EMPLOYER ID NO

46-1571879



ADDRESS


EMPLOYER ID NO

46-1030450


WILLETT (AIV) SELECT INVESTORS I LP

ADDRESS


EMPLOYER ID NO

26-1633115

45 STATEMENT(S) 1510531111 737725 BLOOMFANFND 2012.04040 THE BLOOMEERG FAMILY FOUNDA BLOOMFA2

TITLE ANDAVRG HRS/WK

CEO & DIRECTOR

5.00

DIRECTOR

0.58

DIRECTOR

0.58

DIRECTOR

0.58

DIRECTOR

0.58

DIRECTOR

0.58

0. 0.

9,400. 0.

9,400. 0.

9,400. 0.

0. 0.

9,400. 0.

EMPLOYEECONPEN- BEN PLAN EXPENSESATION CONTRIB ACCOUNT

0.

0.

0.

0.

0.

0.

O S

THE BLOOMBERG FAMILY FIIDATION INC

14 20-5602483


WILL,ETP (AIV) SELECT INVESTORS I LP

ADDRESS

C/O WII1LETT ADVISORS LLC, 25 E 78TH STREETNEW YORK, NY 10075

EMPLOYER ID NO

26-1633115

FORM 990-PF PART VIII - LIST OF OFFICERS, DIRECTORS STATEMENT 16TRUSTEES AND FOUNDATION MANAGERS

NAME AND ADDRESS

PATRICIA E. HARRISC/O GELLER & CO, 909 THIRD AVE.,16TH FLOORNEW YORK, NY 10022

TENLEY ALBRIGHTC/O GELLER & CO, 909 THIRD AVE.,16TH FLOORNEW YORK, NY 10022

EMMA BLOOMBERGC/O GELLER & CO, 909 THIRD AVE.,16TH FLOORNEW YORK, NY 10022

GEORGINA BLOOMBERGC/O GELLER & CO, 909 THIRD AVE.,16TH FLOORNEW YORK, NY 10022

CORY A. BOOKERC/O GELLER & CO, 909 THIRD AVE.,16TH FLOORNEW YORK, NY 10022

DAVID L. BORENC/O GELLER & CO, 909 THIRD AVE.,16TH FLOORNEW YORK, NY 10022

46 STATEMENT(S) 15, 1610531111 737725 BLOOMF.ANFND 2012.04040 THE BLOOMBERG FAMILY FOTJNDA BLOOMFA2

C

9,400.

9,400.

9,400.

9,400.

9,400.

9,400.

9,400.

18,500.

9,400.

0.

20-5602483

0. 0.

0. 0.

0. 0.

0. 0.

0. 0.

0. 0.

0. 0.

0. 0.

0. 0.

0. 0.

THE BLOOMBERG FAMILY 46DATI0N INC

JOHN ELLIS BUSH DIRECTORC/O GELLER & CO, 909 THIRD AVE.,16TH FLOOR 0.58NEW YORK, NY 10022

ELAINE L. CHAO DIRECTORC/O GELLER & CO, 909 THIRD AVE.,16TH FLOOR 0.58NEW YORK, NY 10022

KENNETH I. CHENAULT DIRECTORC/O GELLER & CO. 909 THIRD AVE.,16TH FLOOR 0.58NEW YORK, NY 10022

D. RONALD DANIEL DIRECTORC/O GELLER & CO, 909 THIRD AVE.,16TH FLOOR 0.58NEW YORK, NY 10022

MANuEL A. DIAZ DIRECTORC/O GELLER & CO, 909 THIRD AVE.,16TH FLOOR 0.58NEW YORK, NY 10022

FIONA DRUCKENMILLER DIRECTORC/O GELLER & CO, 909 THIRD AVE.,16TH FLOOR 0.58NEW YORK, NY 10022

WALTER ISAACSON DIRECTORC/O GELLER & CO, 909 THIRD AVE.,16TH FLOOR 0.58NEW YORK, NY 10022

MAYA LIN DIRECTORC/O GELLER & CO, 909 THIRD AVE.,16TH FLOOR 0.58NEW YORK, NY 10022

JOHN J. MACK DIRECTORC/O GELLER & CO, 909 THIRD AVE.,16TH FLOOR 0.58NEW YORK, NY 10022

REVERAND JOSEPH M. MCSHANE DIRECTORC/O GELLER & CO, 909 THIRD AVE.,16TH FLOOR 0.58NEW YORK, NY 10022

47 STATEMENT(S) 1610531111 737725 BLOOMFANFND 2012.04040 THE BLOOMBERG FAMILY FOtINDA BLOOMFA2

THE BLOONBERG FAMILY P'1DATION INC

MICHAEL G. MULLEN DIRECTORC/O GELLER & CO, 909 THIRD AVE.,16TH FLOOR 0.58NEW YORK, NY 10022

SAM NUNN DIRECTORC/O GELLER & CO. 909 THIRD AVE.,16TH FLOOR 0.58NEW YORK, NY 10022

SAMUEL J. PALMISANO DIRECTORC/O GELLER & CO, 909 THIRD AVE.,16TH FLOOR 0.58NEW YORK, NY 10022

HENRY MERRITT PAULSON, JR. DIRECTORC/O GELLER & CO, 909 THIRD AVE.,16TH FLOOR 0.58NEW YORK, NY 10022

ALFRED SOMMER DIRECTORC/O GELLER & CO, 909 THIRD AVE.,16TH FLOOR 0.58NEW YORK, NY 10022

MARTIN SORRELL DIRECTORC/O GELLER & CO, 909 THIRD AVE.,16TH FLOOR 0.58NEW YORK, NY 10022

ANNE TATLOCK DIRECTORC/O GELLER & CO, 909 THIRD AVE.,16TH FLOOR 0.58NEW YORK, NY 10022

TOTALS INCLUDED ON 990-PF, PAGE 6, PART VIII

20-5602483

9,400. 0. 0.

9,400. 0. 0.

9,400. 0. 0.

9,400. 0. 0.

9,400. 0. 0.

9,400. 0. 0.

9,400. 0. 0.

197,100. 0. 0.


.

THE BLOOMBERG FAMILY F1DATION INC I 20-5602483

FORM 990-PF EXPENDITURE RESPONSIBILITY STATEMENT STATEMENT 17PART Vu-B, LINE 5C

GRANTEE'S NAME

EL PODER DEL CONSUMIDOR, A.0

GRANTEE'S ADDRESS

JUAREZ 67-4, COL. SANTA URSULA COAPAC.P. 04650, MEXICO, D.F., MEXICO

GRANT AMOUNT DATE OF GRANT AMOUNT EXPENDED

950,000. 06/21/12 877,381.

PURPOSE OF GRANT

TO SUPPORT THE INITIATIVE TO COMBAT OBESITY IN MEXICO

DATES OF REPORTS BY GRANTEE

02/04/13, 07/16/13

ANY DIVERSION BY GRANTEE

NOT TO OUR KNOWLEDGE

RESULTS OF VERIFICATION

N/A


THE BLOOMBERG FAMILY FtDATION INC

20-5602483

GRANTEE'S NAME

INSTITTJTO NACIONAL DE SALUD PUBLICA

GRANTEE'S ADDRESS

UNIVERSIDAD #655 COLONIA SANTA MARIA AHUACATITLANC.P. 62100, CUERNAVACA, MOR. , MEXICO

GRANT AMOUNT DATE OF GRANT AMOUNT EXPENDED

350,750. 07/11/12 313,933.

PURPOSE OF GRANT

TO SUPPORT THE INITIATIVE TO COMBAT OBESITY IN MEXICO

DATES OF REPORTS BY GRANTEE

01/31/2013, 08/30/2013

ANY DIVERSION BY GRANTEE

NOT TO OUR KNOWLEDGE

RESULTS OF VERIFICATION

N/A


rL

0 V

THE BLOOMBERG FAMILY FOUNDATION INC.

Action of Sole Memberin Lieu of a Meeting

I, Michael R. Bloomberg, the undersigned, being the sole Member of TheBloomberg Family Foundation Inc., a Delaware non-stock, non-profit corporation (the"Foundation"), do hereby state that the following actions were taken on this day pursuant toSection 11 of Article II of the Third Amended Bylaws of the Foundation (as defmed herein) andSection 228(b) of the General Corporation Law of the State of Delaware:

WHEREAS, by an instrument titled "Action of Sole Member in Lieu of aMeeting" and dated March 31, 2010, Michael R. Bloomberg, as sole Member of the Foundation,repealed the bylaws for the regulation of the affairs of the Foundation and replaced them with theAmended and Restated Bylaws of the Foundation (the "Amended Bylaws"); and

WHEREAS, by an instrument titled "Action of Sole Member in Lieu of aMeeting" and dated May 10, 2010, Michael R. Bloomberg, as sole Member of the Foundation,repealed the Amended Bylaws for the regulation of the affairs of the Foundation and replacedthem with the Second Amended and Restated Bylaws of the Foundation (the "Second AmendedBylaws"); and

WHEREAS, by an instrument titled "Action of Sole Member in Lieu of aMeeting" and dated May 13, 2010, Michael R. Bloomberg, as sole Member of the Foundation,repealed the Second Amended Bylaws for the regulation of the affairs of the Foundation andreplaced them with the Third Amended and Restated Bylaws of the Foundation (the "ThirdAmended Bylaws"); and

WHEREAS, by an instrument titled "Action of Sole Member in Lieu of aMeeting" and dated September 28, 2011, Michael R. Bloomberg, as sole Member of theFoundation, repealed the Third Amended Bylaws for the regulation of the affairs of theFoundation and replaced them with the Fourth Amended and Restated Bylaws of the Foundation(the "Fourth Amended Bylaws"); and

WHEREAS, Article X of the Fourth Amended Bylaws provides that theBylaws may be amended, altered or repealed by the written consent of all the Members without ameeting; and

WHEREAS, Michael R. Bloomberg, as sole Member of the Foundation,desires to repeal the Fourth Amended Bylaws and replace them with amended and restated bylaws,entitled the "Fifth Amended and Restated Bylaws of The Bloomberg Family Foundation Inc."and annexed hereto as Exhibit A (the "Fifth Amended Bylaws").

NOW, THEREFORE, BE IT

7449760.4

HWgel 19

RESOLVED, that the Fifth Amended Bylaws be and hereby are approvedand adopted as the bylaws of the Foundation, and, together with this Action of Sole Member inLieu of a Meeting, the certificate of incorporation and notice of filing thereof by the DelawareSecretary of State, shall be inserted in the minute book of the Foundation.

IN WITNESS WHEREOF, the undersigned has subscribed this Action of Sole

Member in Lieu of a Meeting as of 5 , 2012.

w_'a...Michael R. Blooberg, Sole Member Date

7449760.4 2

SO

EXHIBIT A

FIFTH AMENDED AND RESTATED BYLAWS OFTHE BLOOMBERG FAMILY FOUNDATION INC.

ARTICLE IOffice and Books

Section 1. Office The Bloomberg Family Foundation Inc. (the"Foundation") shall have offices at such places, either within or without the State of Delaware,as the Board of Directors (the "Board") may determine from time to time.

Section 2. Books and Records There shall be kept at the office of theFoundation correct and complete books of account of the activities and transactions of theFoundation including a minute book, which shall contain a copy of the Certificate ofIncorporation and all amendments thereto, a copy of these Bylaws and minutes of all meetings ofthe Members, the Board and all committees of the Board.

ARTICLE IIMembers

Section 1. a. Members The initial Member of the Foundation shall beMichael R. Bloomberg (the "Initial Member"). The Initial Member shall have the power toappoint such person or persons, as the Initial Member determines to be advisable, as additionalMember or Members. Upon the death of the Initial Member or the resignation of the InitialMember at a time when there are no other Members then acting, (i) there shall be no Members ofthe Foundation and (ii) no rights, powers, obligations or duties of the Members shall survive theoccurrence of any such event. Notwithstanding the foregoing, during any period in which (i) theInitial Member is Incapacitated (as hereinafter defined) and (ii) there are no other Members ofthe Foundation, for the purposes of these Bylaws, there shall be deemed to be no Members of theFoundation for such period of Incapacity (as hereinafter defined).

b. The Initial Member shall be deemed to have an"Incapacity" or to be "Incapacitated" for purposes of these Bylaws when (i) a valid court orderexists ruling the Initial Member to be legally unable to act on the Initial Member's own behalf orappointing a guardian or conservator of the Initial Member's property to act on behalf of theInitial Member, (ii) the Initial Member is unable to conduct business and financial affairs, whichinability shall be deemed to exist or to terminate when so certified in writing by two licensedphysicians then attending the person to whom such certification applies (neither of whom arerelated by blood or marriage to any Member, Director or Officer at such time) or (iii) the InitialMember has been missing for longer than 60 days and cannot be located with reasonable effortor the Initial Member is being detained under duress where the Initial Member is unableeffectively and prudently to look after financial matters. Such Incapacity shall be deemed tocontinue until such court order, certificates and/or circumstances have become inapplicable orhave been revoked; in such event, the Initial Member shall resume his role as the Initial Memberof the Foundation.

7449760.4

. S

c. During any period in which there are no Members asdetermined pursuant to subsection La of this Article, the Directors shall be the Memberspursuant to subsection 102(a)(4) of the General Corporation Law of the State of Delaware (the"GCLD"). Said Directors shall not hold any of the rights, powers, obligations or dutiesconferred to the Members pursuant to Article III, Article IV and Article X hereunder.

Section 2. Term Each Member shall serve until the earliest to occur of (i)the resignation of such Member, (ii) the removal of such Member or (iii) the death of the InitialMember.

Section 3. Removal Any Member appointed by the Initial Member maybe removed, with or without cause, by the Initial Member at a meeting of the Members or bywritten consent of the Initial Member. The Initial Member may not be removed.

Section 4. Resignation Any Member may resign at any time. Suchresignation shall be made in writing or by electronic transmission and shall take effect at the timespecified therein, and if no time be specified, at the time of its receipt by the ChiefAdministrative Officer. The acceptance of a resignation shall not be necessary to make iteffective, unless so specified therein. The Chief Administrative Officer shall present such noticeof resignation at the first meetings of the Members and Directors following its receipt.

Section 5. Annual Meeting The Members shall convene for an annualmeeting of the Members each year on such date and at such time and place, within or without theState of Delaware, as shall be designated in the notices or waivers of notice relating to suchmeeting for the purpose of the election of the initial Directors of the Foundation, as provided inSection 4 of Article III hereunder, and/or the transaction of such other business as may comebefore the Members.

Section 6. Special Meetings Special meetings of the Members for anypurpose may be held either within or without the State of Delaware and may, unless otherwiseprescribed by statute, be called at any time by the Board or by the Chief Executive Officer andshall be called by the Chief Executive Officer or by the Chief Administrative Officer upon thewritten demand of a majority of the Members, which demand shall be delivered to the ChiefExecutive Officer or Chief Administrative Officer and shall specify the date and time of themeeting, which shall not be less than sixty (60) days or more than ninety (90) days from the dateof said demand. Upon receiving any such written demand, the Chief Executive Officer or ChiefAdministrative Officer shall give notice of the date, time and place of the special meeting to eachmember in accordance with the provisions of Section 7 of this Article. No business other thanthat specified in the notice of special meeting of the Members shall be transacted at such meetingwithout the unanimous consent of all Members present at such meeting.

Section 7. Notice of Meetings Notice of the time and place of anymeeting of the Members, whether annual or special, shall be given to each Member entitled tovote thereat, at least ten (10) days but not more than sixty (60) days before the day of themeeting. Notice of any adjourned meeting need not be given except by announcement at themeeting so adjourned, unless otherwise ordered in connection with such adjournment. Suchfurther notice, if any, shall be given as may be required by law.

7449760.4 4

Section 8. Quorum A majority of the Members shall be necessary toconstitute a quorum for the transaction of business. In the absence of a quorum, or when aquorum is present, a meeting may be adjourned from time to time by a vote of the majority of theMembers present or represented by proxy, without notice other than announcement at themeeting and without further notice to any absent Member. When a quorum is initially present, itmay not be broken by the subsequent withdrawal of any Members.

Section 9. Voting At every meeting of the Members, each Member shallbe entitled to one vote on all matters. All actions to be taken by vote of the Members shall beauthorized by a majority of the members present or represented by proxy at a meeting of theMembers, except as otherwise required by law. At all meetings of the Members, each Membermay vote either in person or by proxy. At all meetings of the Members where a Member isparticipating by means of remote communication, said Member may submit his, her or its ballotby electronic transmission.

Section 10. Proxies A Member may authorize another person or personsto act for said Member by written proxy. No proxy shall be valid after the expiration of eleven(11) months from the date thereof unless otherwise provided in the proxy. Every proxy shall berevocable at the pleasure of the Member executing it. The authority of the holder of a proxy toact shall not be revoked by the incompetence or death of the Member who executed the proxyunless, before the authority is exercised, written notice of an adjudication of such incompetenceor of such death is received by the corporate Officer responsible for maintaining the list ofMembers.

Section 11. Action Without a Meeting Any action required or permittedto be taken at any annual or special meeting of the Members may be taken without a meeting,without prior notice and without a vote, if a consent in writing or by electronic transmission,setting forth the action so taken, shall be signed or transmitted, as the case may be, by theMembers having not less than the minimum number of votes that would be necessary toauthorize or take such action at a meeting at which all Members entitled to vote thereon werepresent and voted and shall be delivered to the Foundation by delivery to its registered office inthe State of Delaware, its principal place of business, or an officer or agent of the Foundationhaving custody of the book in which proceedings of meetings of Members are recorded. Promptnotice of the taking of the corporate action without a meeting by less than unanimous writtenconsent shall be given to those Members who have not consented in writing.

Section 12. Meeting by Means of Telecommunications Any one or moreof the Members may participate in a meeting of the Members by means of a conferencetelephone or similar telecommunications equipment allowing all persons participating in themeeting to hear each other at the same time or by means of remote communication. Participationby such means shall constitute presence in person at a meeting.

Section 13. Delegation of Duties to the Board The Members may, inwriting, authorize the Board to act in their place and stead with respect to any action required orpermitted to be taken by the Members of the Foundation pursuant to these Bylaws, and suchdelegation to the Board may be revoked by the Members at any time.

7449760.4 5

11

ARTICLE IIIDirectors

Section 1. Responsibilities The business and affairs of the Foundationshall be managed under the direction of the Board, unless otherwise provided hereunder.

Section 2. Classification There shall be three (3) classes of Directors:Class I, Class II and Class III (collectively, the "Directors").

Section 3. Number Anything contained herein to the contrarynotwithstanding, there shall always be at least sixteen (16) Directors of the Foundation and thereshall not be more than twenty-five (25) Directors of the Foundation. There shall always be atleast eight (8) Class II Directors and eight (8) Class III Directors.

Section 4. Election

a. Initial Class I Directors The initial Class I Directors (the"Initial Class I Directors") shall be elected at the first annual meeting of the Members followingthe adoption by the Foundation of the Third Amended and Restated Bylaws of the Foundation(the "Initial Meeting") by a vote of the majority of the Members. There shall be no successors tothe Initial Class I Directors.

b. Initial Class II Directors The initial Class II Directors (the"Initial Class II Directors") shall be elected at the Initial Meeting of the Members by a vote ofthe majority of the Members.

c. Initial Class III Directors The initial Class ifi Directors(the "Initial Class III Directors") shall be elected at the Initial Meeting of the Members by a voteof the majority of the Members.

d. Successors to Initial Class II Directors The successors tothe Initial Class II Directors (each, a "Class II Director") shall be elected at the Annual Meetingof the Board (as hereinafter defined) that is held upon the expiration of the term of the InitialClass II Directors. The Directors currently serving in office (the "Current Directors") and theoutgoing Directors whose term expired as of the date of the Annual Meeting at issue (the"Outgoing Directors") shall elect a Class II Director by majority vote. When selecting the ClassII Directors, the Current Directors and the Outgoing Directors shall first consider electing suchindividuals designated by resolution of the Members, if any, but shall not be under anyobligation to elect such individuals.

e. Successors to Initial Class III Directors The successors tothe Initial Class III Directors (each, a "Class III Director") shall be elected at the Annual Meetingof the Board that is held upon the expiration of the term of the Initial Class Ill Directors, TheCurrent Directors and the Outgoing Directors shall elect a Class III Director by majority vote.When selecting the Class III Directors, the Current Directors and the Outgoing Directors shallfirst consider electing some or all of the Initial Class II Directors, but shall not be under anyobligation to elect some or all of the Initial Class II Directors.

7449760.4

f. Successors to Class II Director A successor to a Class IIDirector (other than an Initial Class II Director) shall be elected at the Annual Meeting of theBoard that is held upon the expiration of the term of such Class II Director. The CurrentDirectors and the Outgoing Directors shall elect the successor of a Class II Director by majorityvote. When selecting the successor of a Class II Director, the Current Directors and theOutgoing Directors shall first consider electing former members of the Board, but shall not beunder any obligation to elect former members of the Board.

g. Successors to Class 111 Directors A successor to a Class IIIDirector (other than an Initial Class Ill Director) shall be elected at the Annual Meeting of theBoard that is held upon the expiration of the term of such Class III Director. The CurrentDirectors and the Outgoing Directors shall elect the successor of a Class III Director by majorityvote. When selecting the successor of a Class III Director, the Current Directors and theOutgoing Directors shall first consider electing former members of the Board, but shall not beunder any obligation to elect former members of the Board.

Section 5. Term

a. Initial Class I Directors The term of an Initial Class IDirector shall commence at the election of said Initial Class I Director and shall expire on theearliest to occur of the death, disqualification, resignation or removal of said Initial Class IDirector. The Initial Class I Directors shall not be subject to term limits hereunder.

b. Initial Class II Directors Except as provided in Section 8 ofthis Article, the term of an Initial Class II Director shall commence at the election of said InitialClass II Director and shall expire at the earlier to occur of (i) the Annual Meeting of the Boardheld in the calendar year that is four (4) years after the calendar year in which said Initial Class IIDirector was elected and (ii) at said Initial Class II Director's death, disqualification, resignationor removal.

c. Initial Class III Directors Except as provided in Section 8of this Article, the term of an Initial Class III Director shall commence at the election of saidInitial Class III Director and shall expire at the earlier to occur of (i) the Annual Meeting of theBoard held in the calendar year that is five (5) years after the calendar year in which said InitialClass III Director was elected and (ii) at said Initial Class III Director's death, disqualification,resignation or removal.

d. Class II Directors and Class III Directors Except asprovided in Section 8 of this Article, the term of a Class II Director and a Class III Director shallcommence at the election of such Director and shall expire at the earlier to occur of (i) theAnnual Meeting of the Board held in the calendar year that is two (2) years after the calendaryear in which said Director was elected and (ii) said Director's death, disqualification,resignation or removal.

e. Directors Serving as Special Assets Committee MembersNotwithstanding the foregoing provisions of this Section and Section 8 of this Article, upon theTrigger Date, as defined below, the term of any SAC Director, as defined below, shall expire onthe later to occur of (i) the expiration of such SAC Director's term as otherwise provided by the

7449760.4 7

. St

provisions of this Section 5 or Section 8 of this Article, as the case may be, and (ii) thecompletion of the duties and the obligations of the SAC Director, as determined by a majorityvote of the Directors other than the SAC Directors. The Board shall elect a Class II Director toserve in addition to an SAC Director who is a Class II Director and a Class III Director to servein addition to an SAC Director who is a Class III Director, and said additional Class II Directoror Class III Director, as the case may be, shall be elected at the Annual Meeting held in thecalendar year in which said SAC Director's term would otherwise have expired as provided bythe provisions of this Section 5 or Section 8 of this Article, as the case may be, provided saidSAC Director is serving at such time. The term of said additional Class II Director or Class IIIDirector, as the case may be, shall be determined by the foregoing provisions of this Section 5.

At the expiration of the term of an SAC Director, other than by death, resignation or removal, asuccessor to said SAC Director shall not be elected by the Board.

i. For purposes of subsection e of this Section 5, the term"Trigger Date" shall mean the earlier to occur of (i) the date that is eighteen (18) months after thetime the Initial Member becomes Incapacitated, provided such Incapacity continued for theduration of the eighteen (18) month period without interruption, and (ii) the death of the InitialMember.

ii. For purposes of subsection e of this Section 5, the termSAC Director shall mean any Director of the Foundation who is serving on the Trigger Date as amember of the Special Assets Committee or has been appointed after the Trigger Date to theSpecial Assets Committee pursuant to Section 16a of this Article.

f. Consecutive Terms Directors shall be eligible for re-election but may not serve consecutive terms except as provided in Section 8 of this Article;provided, however, that any Director of the Foundation who is serving as a member of theSpecial Assets Committee at the Trigger Date shall be eligible to serve for a consecutive term asprovided in paragraph e of this Section 5.

Section 6. Resignation Any Director acting hereunder may resign and bedischarged from office by delivery to the Directors of an instrument of resignation. Suchinstrument shall be made in writing, signed and acknowledged by such resigning Director, or byelectronic transmission. Such instrument shall specify the date at which such resignation shalltake effect, which date shall be at least thirty (30) days after the delivery thereof; provided,however, that such resignation may take effect in fewer than thirty (30) days after the delivery ofsuch instrument with the consent of a majority of the Directors.

Section 7. Removal Any Director may be removed, with or withoutcause, by a vote of a majority of the Members at an annual meeting of the Members, at anyspecial meeting of the Members called for that purpose or pursuant to Section 11 of Article IIhereunder. If there are no Members, any Director may be removed, with or without cause, by avote of two-thirds of the Directors at an Annual Meeting of the Board, at any special meeting ofthe Board called for that purpose or pursuant to Section 13 of this Article; provided, however,that the Directors shall not have the authority to remove an Initial Class I Director, and providedfurther, however, that the Directors shall not have the power to remove, other than for cause, aDirector who is a member of the Special Assets Committee appointed by the Initial Member.Any Director who has been removed pursuant to this section shall not act as or be designated to

7449760.4

act as a Director hereunder. Notwithstanding the foregoing, the Members may, by a vote of amajority of the Members or by majority written consent, provide that an individual who has beenremoved as Director shall be eligible for re-election.

Section 8. Newly Created Directorships and Vacancies Newly createddirectorships and any vacancies in the Class II or Class III Directors of the Board occurringduring the term of a Class II or Class III Director, as the case may be, by reason of death,resignation, disqualification, removal or for any other cause may be filled by vote of a majorityof the Directors. Any Initial Class II Director or Class II Director, as the case may be, so electedby the Directors shall hold office until the election and qualification of a successor Class IIDirector at the next succeeding Annual Meeting at which Class II Directors are elected, and anyInitial Class III Director or Class III Director, as the case may be, so elected by Directors shallhold office until the election and qualification of a successor Class III Director at the nextsucceeding Annual Meeting at which Class III Directors are elected. Notwithstanding theprovisions of subsection f of Section 5 of this Article, any individual elected hereunder to fill avacancy may be elected to serve as a successor Class II or Class III Director, as the case may be,for the term immediately following the term for which such individual was elected to fill avacancy, and such election shall occur at the next succeeding Annual Meeting at which Class IIor Class III Directors, as the case may be, are elected.

Section 9. Regular Meetings The Board shall convene for an annualmeeting of the Directors (the "Annual Meeting") in the month of June of each year, or asotherwise determined by the Board, on such date and at such time and place, within or withoutthe State of Delaware, as shall be designated in the notices or waivers of notice relating to suchmeeting for the purpose of the election of Directors and Officers and the transaction of suchother business as may come before the Board. Other regular meetings may be held at such timesas may be determined from time to time by the Chairperson on such date and at such time andplace, within or without the State of Delaware, as shall be designated in the notices or waivers ofnotice relating to such meeting for the purpose of the transaction of such business as may comebefore the Board. Notice of the time and place of any regular meeting of the Board shall begiven to each Director entitled to vote thereat at least five (5) days before the day of the meeting.

Section 10. Special Meetings Special meetings of the Board may becalled by the Chairperson of the Board by giving notice to each Director entitled to vote thereatat least two (2) days before the day of the meeting. On the written request of a majority of theDirectors, special meetings shall be called by the Chief Administrative Officer by giving noticeto each Director entitled to vote thereat at least five (5) days before the day of the meeting. Ineach case, the person or persons calling the special meeting shall fix a reasonable time and placefor the meeting.

Section 11. Quorum A majority of the Directors shall be necessary toconstitute a quorum for the transaction of business. In the absence of a quorum, or when aquorum is present, a meeting may be adjourned from time to time by a vote of the majority of theDirectors present, without notice other than announcement at the meeting and without furthernotice to any absent Director. When a quorum is initially present, it may not be broken by thesubsequent withdrawal of any Directors.

7449760.4 9

. I

Section 12. Voting At every meeting of the Board, each Director shall beentitled to one vote on all matters. All actions to be taken by vote of the Board shall beauthorized by a majority of the Directors present at any such meeting, except as may otherwisebe provided by law or these Bylaws.

Section 13. Action Without a Meeting Any action required or permittedto be taken by the Board or any committee thereof may be taken without a meeting if allmembers of the Board or the committee, as the case may be, consent thereto in writing or byelectronic transmission to the adoption of a resolution authorizing the action. Said resolution,writing(s) and electronic transmission(s) shall be filed with the minutes of the proceedings of theBoard or committee, as the case may be.

Section 14. Meeting by Means of Telecommunications Any one or moremembers of the Board or any committee thereof may participate in a meeting of the Board orsuch committee by means of a conference telephone or similar communications equipmentallowing all persons participating in the meeting to hear each other at the same time.Participation by such means shall constitute presence in person at a meeting.

Section 15. Chairperson

a. The Members, by majority consent, shall designate aChairperson of the Board. The Chairperson shall be selected from among the Directors. If theChairperson ceases for any reason to act as a Director or Chairperson, the Members by majorityconsent, or if there are no Members, the Directors by majority consent, shall designate asuccessor Chairperson. The Chairperson may be removed from his or her position asChairperson of the Board by a vote of two-thirds of the Members, or if there are no Members, bya vote of two-thirds of the Directors,

b. The Chairperson of the Board shall preside at all meetingsof the Board at which the Chairperson is present. The Chairperson of the Board shall also do andperform such other duties as may, from time to time, be assigned by the Directors.

Section 16. Committees

a. Standing Committees The Members shall have the powerto (i) establish such standing committees of the Board as the Members may deem desirable forthe furtherance of the objects and purposes of the Foundation, (ii) appoint the members of suchstanding committees, (iii) delegate to such standing committees such powers as, in the discretionof the Members and consistent with applicable law, are necessary or desirable, and (iv) changethe composition of any such standing committee at such times as the Members in their absolutediscretion determine to be necessary or desirable. If there are no Members, the Directors shallhave the power to (i) establish such standing committees of the Board as the Directors may deemdesirable for the furtherance of the objects and purposes of the Foundation, (ii) appoint themembers of such standing committees, (iii) delegate to such standing committees such powersas, in the discretion of the Board and consistent with applicable law, are necessary or desirable,and (iv) change the composition of any such standing committee at such times as the Board in itsabsolute discretion determines to be necessary or desirable; provided, however, that at any timeafter the Initial Member's death or Incapacity, (1) the Directors shall not have the power to

7449760.4 10

remove, other than for cause, a member of the Special Assets Committee appointed by the InitialMember, and (2) the Directors shall have the power to appoint members of the Special AssetsCommittee only to fill a vacancy occurring by reason of the death, resignation, removal for causeor expiration of the term of a Director.

b. Additional Committees The Directors shall have the powerto (i) establish from time to time such additional committees of the Board as the Directors maydeem desirable for the furtherance of the objects and purposes of the Foundation, (ii) appoint themembers of such committees, (iii) delegate to such committees such powers as, in the discretionof the Board and consistent with applicable law, are necessary or desirable, (iv) change thecomposition of any such committee at such times as the Board in its absolute discretiondetermines to be necessary or desirable, and (v) adjourn any such committee upon thecompletion of its duties and obligations, as determined by the Directors.

c. The Initial Chief Executive Officer (as defined herein) shallact as a member of any committee created hereunder. All additional committee members shallbe appointed from among the Directors. If a committee member ceases to act as Director orInitial Chief Executive Officer, as the case may be, for any reason, such committee member shallcease to serve on any committee to which such committee member was appointed. The InitialChief Executive Officer shall be the chairperson of each committee. Notwithstanding theforegoing, the Initial Chief Executive Officer or the Chief Executive Officer, as the case may be,shall not act as a member or be the chairperson of the Audit Committee.

d. At the Annual Meeting of the Board and at such times asthe Board directs, each committee shall provide a report of its actions and such actions shall besubject to amendment by the Directors; provided, however, that any such amendment shall notadversely affect the rights of any third party.

e. There shall be the following standing committees of theBoard and any such other standing committees as the Members or Directors, as the case may be,shall establish from time to time:

i. Investment Committee The Investment Committeeshall assist the Board with overseeing the management of the Foundation's assets. TheInvestment Committee shall be responsible for formulating the investment policies of theFoundation, subject to the approval of the Board, and monitoring the management of theFoundation's assets to ensure compliance with the Foundation's investment policies.

ii. Program Committee The Program Committee shallassist the Board with developing and overseeing the program and grant-making policies of theFoundation.

iii. Special Assets Committee The Special AssetsCommittee shall assist the Board with managing certain assets of the Foundation.

iv. Audit Committee The Audit Committee shall assist theBoard with monitoring the Foundation's financial reporting and financial reporting processes.The Audit Committee shall review the Foundation's policies, practices and compliance with

7449760.4 11

regulations concerning financial reporting, tax filings, accounting and conflicts of interest, andoversee the Foundation's relationship with its outside auditor.

Section 17. Compensation

a. The Directors may be reimbursed for all of their directexpenses, including but not limited to travel expenses, in serving the Foundation. Suchreimbursements shall be approved by the Chief Executive Officer, taking into consideration therequirements of Section 4941 (d)(2)(E) and (G) of the Internal Revenue Code of 1986, asamended (the "Code"), and the Treasury Regulations promulgated thereunder. If the ChiefExecutive Officers is unable or unavailable to approve such reimbursements, the Members maydesignate an individual or individuals to approve such reimbursements. Notwithstanding theforegoing, no Director shall participate (in any capacity) in a vote on matters pertaining to suchDirector's reimbursement.

b. The Directors may be reasonably compensated for personalservices that are reasonable and necessary to carry out the exempt purposes of the Foundation.Such compensation shall be determined by a vote of the majority of the Members from time totime, taking into consideration the requirements of Section 4941 (d)(2)(E) of the Code, and theTreasury Regulations promulgated thereunder. Notwithstanding the foregoing, the compensationof the Directors shall be fixed as of the date of death of the Initial Member (the "FinalCompensation Amount"); provided, however, that each year on January 1st, the FinalCompensation Amount shall be adjusted for inflation by multiplying the Final CompensationAmount by the sum of one plus the percentage by which the CPI for the immediately precedingDecember exceeds the CPI for December of the year prior to the Initial Member's date of death,and such adjusted amount shall be rounded to the next lowest multiple of $100. Any referenceherein to the term "CPI" shall mean the Consumer Price Index for All Urban Consumers (USCity Average, All Items) as published by the Bureau of Labor Statistics (or the most comparablesuccessor index compiled by such agency or its successor). The compensation of the Directors(other than reimbursements) may not be determined by a vote of the Directors.

Section 18. Rules and Regulations. The Board may from time to timeadopt such rules and regulations as it may deem advisable to carry out the affairs of theFoundation.

ARTICLE IVOfficers

Section 1. Number There shall be a Chief Executive Officer and a ChiefAdministrative Officer of the Foundation. Additional Officers of the Foundation may include aChief Investment Officer, a Chief Financial Officer and such other Officers or assistant Officersas the Chief Executive Officer may from time to time determine. The initial Chief ExecutiveOfficer (the "Initial Chief Executive Officer") shall be a Director. Any Officer other than theInitial Chief Executive Officer may, but need not, be a Director or Member. Any two or moreoffices may be held by the same person.

7449760.4 12

Section 2. Election of Officers

a. Election of Chief Executive Officer The Initial ChiefExecutive Officer shall be elected at the annual meeting of the Members by a vote of themajority of the Members. The successor to the Initial Chief Executive Officer and all futuresuccessor Chief Executive Officers shall be elected at the annual meeting of the Members by avote of the majority of the Members, or if there are no Members, at the Annual Meeting of theBoard by a vote of the majority of the Directors. All references hereunder to the Chief ExecutiveOfficer shall apply to the Initial Chief Executive Officer and all Successor Chief ExecutiveOfficers.

b. Election of Other Officers The Chief Executive Officer (i)shall appoint the Chief Administrative Officer and (ii) may appoint such additional Officers,including a Chief Investment Officer, a Chief Financial Officer and such assistant Officers as theChief Executive Officer may determine from time to time.

Section 3. [rn The Initial Chief Executive Officer shall not be subjectto a term limit hereunder. Successor Chief Executive Officers shall serve for such term as amajority of the Members shall determine from time to time, or if there are no Members, as amajority of Directors shall determine from time to time. Chief Administrative Officers and suchother Officers or assistant Officers (as determined by the Chief Executive Officer) shall serve forsuch term as the Chief Executive Officer shall determine from time to time.

Section 4. Chief Executive Officer

a. The Chief Executive Officer shall have general executivecharge management and control of the properties and operations of the Foundation in theordinary course of its business, with all such powers with respect to such properties andoperations as may be reasonably incident to such responsibilities. The Chief Executive Officershall preside at all meetings of the Board in the absence of the Chairperson of the Board. TheChief Executive Officer shall keep the Board fully informed and shall consult with the Boardconcerning the business of the Foundation. Notwithstanding the foregoing, the Chief ExecutiveOfficer shall have such authority and perform such duties in the management of the Foundationas are provided in these Bylaws or as may be determined by resolution of the Board, where suchresolution is not inconsistent with these Bylaws.

b. In addition to those powers conferred in the paragraphabove, the Initial Chief Executive Officer shall have the power to make and receive grants onbehalf of the Foundation. The Initial Chief Executive Officer may execute, make, verify,acknowledge, deliver, file and record any and all certificates, instruments, agreements anddocuments and take any and all other actions as may be necessary or desirable in the Initial ChiefExecutive Officer's judgment in order to carry out the making and receiving of such grants.

Section 5. Chief Administrative Officer The Chief AdministrativeOfficer shall keep the minutes of meetings of the Board and Members, shall have the custody ofthe seal of the Foundation, and shall affix the seal to documents when authorized to do so. TheChief Administrative Officer shall perform all duties customary to the office of secretary and

7449760.4 13

such other duties as may be determined from time to time by resolution of the Board, where suchresolution is not inconsistent with these Bylaws.

Section 6. Chief Investment Officer If appointed pursuant to Section 2 ofthis Article, the Chief Investment Officer shall (i) have the care and custody of the portfolio ofassets of the Foundation and shall manage and monitor such assets as is in the best interests ofthe Foundation, (ii) consult with the Investment Committee as to the management of such assets,and (iii) shall be responsible for such other duties as may be determined from time to time byresolution of the Board, where such resolution is not inconsistent with these Bylaws.

Section 7. Chief Financial Officer If appointed pursuant to Section 2 ofthis Article, the Chief Financial Officer shall be responsible for the financial planning and recordkeeping of the Foundation and such other duties as may be determined from time to time byresolution of the Board, where such resolution is not inconsistent with these Bylaws.

Section 8. Removal The Chief Executive Officer shall have the power toremove subordinate Officers, agents and employees with or without cause. Notwithstanding theforegoing, any Officer, agent or employee may be removed at anytime, with or without cause, byvote of two-thirds of the Directors at an Annual Meeting of the Board or at a special meeting ofthe Board called for that purpose.

Section 9. Vacancies

a. i. In the event any office (other than the ChiefExecutive Office) of the Foundation (A) has been filled by the Chief Executive Officer pursuantto Section 2 of this Article, and (B) subsequently becomes vacant by reason of death, resignation,disqualification, removal or for any other cause, the Chief Executive Officer shall have thepower to appoint an individual to fill such vacancy, and the individual so elected shall holdoffice and serve until the regular election and qualification of a successor.

ii. Notwithstanding the foregoing, if the office of the ChiefAdministrative Officer becomes vacant and the Chief Executive Officer shall fail to appoint anindividual to fill such vacancy within sixty (60) days of the date on which the office becamevacant (or waives his or her power to appoint within the sixty (60) day period), or if there is noChief Executive Officer, a majority of the Members, or if there are no Members, a majority ofthe Directors may elect an individual to fill such vacancy, and the individual so elected shall holdoffice and serve until the regular election and qualification of a successor.

b. If the office of the Chief Executive Officer becomes vacantby reason of death, resignation, disqualification, removal or for any other cause, a majority of theMembers, or if there are no Members, a majority of Directors, may elect an individual to fill suchvacancy, and the individual so elected shall hold office and serve until the regular election andqualification of a successor.

Section 10. Compensation of Officers, Employees and Agents TheOfficers, employees, agents and representatives of the Foundation may be reimbursed for all oftheir direct expenses in serving the Foundation and, in addition, shall be reasonably compensatedfor personal services that are reasonable and necessary to carry out the exempt purposes of the

7449760.4 14

I IHE 19

Foundation. Said reimbursements and compensation shall be approved by a majority of theMembers, or if there are no Members, by a majority of the Directors, taking into considerationthe requirements of Section 4941(d)(2)(E) and (G) of the Code, and the Treasury Regulationspromulgated thereunder. Said compensation shall be consistent with (i) the compensationreceived by the Officers, employees, agents and representatives of other large nationalfoundations providing similar services, (ii) current compensation surveys compiled byindependent firms or (iii) actual written offers from similarly situated organizations.Notwithstanding anything herein, no Officer shall participate (in any capacity) in a vote onmatters pertaining to his or her compensation or reimbursement,

ARTICLE VIndemnification

Section 1. Non-derivative Action The Foundation may, to the fullestextent now or hereafter permitted by law, indemnify any person made, or threatened to be made,a party to any action or proceeding, whether civil, criminal, administrative or investigative (a"proceeding"), by reason of the fact that he or she, or a person for whom he or she is the legalrepresentative, was a Director, Officer, employee, agent or representative of the Foundation, or isor was serving at the request of the Foundation as a Director, Officer, employee, agent orrepresentative of another corporation or of a partnership, joint venture, trust, enterprise or non-profit entity, including service with respect to employee benefit plans, against judgments, tines,amounts paid in settlement and reasonable expenses, including attorneys' fees reasonablyincurred by such person, if such person acted in good faith for a purpose he or she believed to bein, or in the case of service for any other corporation or any partnership, joint venture, trust,enterprise, non-profit entity or employee benefit plan, not opposed to, the best interests of theFoundation, and, with respect to a criminal action or proceeding, had no reasonable cause tobelieve his or her conduct was unlawful. The termination of any action, suit or proceeding byjudgment, order, settlement, conviction, or upon a plea of nolo contendere or its equivalent, shallnot, of itself, create a presumption that the person did not act in good faith and in a manner thatthe person reasonably believed to be in or not opposed to the best interests of the Foundation,and, with respect to any criminal action or proceeding, had reasonable cause to believe that theperson's conduct was unlawful. The Foundation may indemnify a person in connection with aproceeding (or part thereof) initiated by such person only if the commencement of suchproceeding (or the applicable part thereof) was authorized in advanced by the Board.

Section 2. Derivative Action The Foundation may, to the fullest extentnow or hereafter permitted by law, indemnify any person made, or threatened to be made, a partyto any suit, action or proceeding by or in the right of the Foundation to procure ajudgment in itsfavor by reason of the fact that he or she, or a person for whom he or she is the legalrepresentative, was a Member, Director, Officer, employee, agent or representative of theFoundation, or is or was serving at the request of the Foundation as a Director, Officer,employee, agent or representative of another corporation or of a partnership, joint venture, trust,enterprise or non-profit entity, including service with respect to employee benefit plans, againstexpenses, including attorneys' fees, actually and reasonably incurred by the person in connectionwith the defense or settlement of such action or suit if the person acted in good faith and in amanner the person reasonably believed to be in or not opposed to the best interest of theFoundation and except that no indemnification shall be made in respect of any claim, issue or

7449760.4 15

matter as to which such person shall have been adjudged to be liable to the Foundation unlessand only to the extent that the Delaware Court of Chancery or the court in which such action orsuit was brought shall determine upon application that despite the adjudication of liability but inview of all the circumstances of the case, such person is fairly and reasonably entitled toindemnity for such expenses which the Delaware Court of Chancery or such other court shalldeem proper.

Section 3. Limitation The Foundation shall not indemnify anyone ifdoing so would constitute an act of self-dealing within the meaning of Section 4941 of the Code,or the Treasury Regulations promulgated thereunder.

ARTICLE VIContracts, Funds, Checks and Investments

Section 1. Cheeks, Notes and Contracts The Initial Chief ExecutiveOfficer has the authority, in the name of and on behalf of the Foundation, to enter into anycontract or to execute and deliver any instrument, or to sign checks, drafts or other orders for thepayment of money or notes or other evidences of indebtedness, including establishing marginaccounts with securities firms. Notwithstanding the foregoing, the Board may authorize anyOfficer or Officers, in the name of and on behalf of the Foundation, to enter into any contract orto execute and deliver any instrument, or to sign checks, drafts or other orders for the payment ofmoney or notes or other evidences of indebtedness, including establishing margin accounts withsecurities firms, and such authority may be general or confined to specific instances. Unless soauthorized by these Bylaws or the Board, no Officer shall have the power or authority to bind theFoundation by any contract or engagement or to render it pecuniarily liable for any purpose or toany amount, with any other institution or firm, corporation or individual.

Section 2. Depositories of Funds All funds of the Foundation nototherwise employed shall be deposited from time to time to the credit of the Foundation in suchbanks, trust companies or other depositories as the Board may select, or as may be selected byany Officer or Officers of the Foundation to whom such power may from time to time bedelegated by the Board.

Section 3. Investments The funds of the Foundation may be retained partin cash or may be invested and reinvested from time to time in such property, real, personal orotherwise, including stocks, bonds or other securities, as the Board may deem desirable.

Section 4. Stock of Other Corporations Unless otherwise determined bythe Board, the Chief Executive Officer shall have full power and authority on behalf of theFoundation to vote, either in person or by proxy, at any meetings of stockholders of anycorporation in which the Foundation may hold stock and at any such meeting may possess andexercise any and all rights and powers incident to the ownership of such stock, which, as theowner thereof, the Foundation may have possessed and exercised if present. The Board mayconfer like powers upon any person or persons from time to time and may revoke any suchpower as granted at its pleasure.

7449760.4 16

ARTICLE VIIFiscal Year

The fiscal year of the Foundation ends on December 31st of each calendaryear.

ARTICLE VIIISeal

The seal of the Foundation shall be circular in form and shall bear thename of the Foundation and the year of its organization.

ARTICLE IXNotices and Waivers

Section 1. Notice of Meetings

a. Whenever under the provisions of these Bylaws, theCertificate of Incorporation or any statute, notice is required to be given to any Director orOfficer, it shall be given personally or by first-class mail, facsimile or electronic transmission, ifthe Director or Officer has consented to receipt by such method, addressed to such Director orOfficer at such address as appears on the records of the Foundation or at such other address asthe Director or Officer may have filed with the Chief Administrative Officer for such purpose. Ifmailed, such notice shall be deemed to have been given for such purpose when deposited in theUnited States mail, with postage thereon prepaid, directed to the Director or Officer at his or heraddress as it appears on the records of the Foundation or at such other address as he or she mayhave filed with the Chief Administrative Officer for such purpose. If sent by facsimile orelectronic transmission, such notice shall be deemed to have been given for such purpose whendirected to the electronic mail address or facsimile number at which the Director or Officer hasconsented to receive notice. Notice of a special meeting shall state the purpose for which it iscalled and shall indicate that it is being issued by or at the direction of the person(s) calling themeeting.

b. When a meeting is adjourned to another time or place, itshall not be necessary to give any notice of the adjourned meeting if the time and place to whichthe meeting is adjourned are announced at the meeting at which the adjournment is taken, and atthe adjourned meeting any business may be transacted that might have been transacted on theoriginal date of the meeting.

Section 2. Waivers of Notice Any Member, Director or Officer may atany time (whether before or after the meeting or other event requiring notice) waive any noticerequired to be given by law, the Certificate of Incorporation or these Bylaws. Notice of ameeting need not be given to any Member, Director or Officer who submits a waiver signed orgiven by telegraph, cable or electronic transmission, whether before or after the meeting. Theattendance of any Member, Director or Officer at a meeting, in person or by proxy, withoutprotesting the lack of notice prior to the conclusion of the meeting shall constitute a waiver ofnotice by said person.

7449760.4 17

Section 3. Use of Electronic Transmission The Foundation is authorizedto use "electronic transmission" as defined in the GCLD to the full extent allowed by the GCLDincluding, but not limited to, the purposes of notices (to the extent that the recipient of any suchnotice has consented to receive such notice by electronic transmission), proxies, waivers,resignations and any other purpose for which electronic transmissions are permitted by theGCLD.

ARTICLE XAmendments

These Bylaws may be amended, altered or repealed at any meeting of theMembers by a vote of a majority of all the Members, or they may be amended, altered orrepealed by the written consent of all the Members without a meeting. If there are no Members,these Bylaws may be amended, altered or repealed at any meeting of the Board by a vote of two-thirds of all the Directors, or they may be amended, altered or repealed by the written consent ofall the Directors without a meeting. Notwithstanding the foregoing, Sections 5 and 17 of ArticleIII and this Article X may not be amended by the Directors.

ARTICLE XIWinding Down

If, for any reason, it shall be in the best interests of the Foundation todissolve, such dissolution shall occur pursuant to Section 276 of the GCLD and Article TENTHof the Certificate of Incorporation. The net assets of the Foundation shall be distributed inaccordance with said Article TENTH.

7449760.4 18

LlF.990-T

Exempt Organization Business Income Tax ReturnlDapartment of the Treasury (and proxy tax under section 6033(e))

Internal Revenue Service calendar year 2012 or other tax year beginning ,and ending

A Li Check box if

Name of organization ( L...J Check box if name changed and see Instructions.) Iaddress changed

B Exempt under section Print THE BLOOMBERG FAMILY FOUNDATION INC

EJ 501(c )( 3 ) or Number, street, and room or suite no. If a P.O. box, see Instructions.[:]408(e) [—]220(e) Type

GELLER & CO, 909 THIRD AVE. NO. 16 FL

0408A L1530(a) City or town, state, and ZIP code

E529(a) NEW YORK, NY 10022

C Book value of all assets I F Group exemption number (see instructions)at end of year 6 Check organization type LX] 501(c) corporation L..J 501(c) trust L_i 401(a) trust

(Employees' trust, seeInstructions.)

20-5602483Unrelated business activity c(See Instructions)

23000

L_.J Other trust3,992, 454,698.

H Describe the organization's primary unrelated business activity. jo. UBTI FROM FLOW THROUGH ACTIVITY.

I During the tax year, was the corporation a subsidiary in an affiliated group or a parent-subsidiary controlled group? ........ 10. U Yes LX] Nolf'Yes,' enter the name and Identifying number of the parent corporation.

J The books are in care of DIANE GUBELLI, C/O GELLER & CO LLCleleohone number 01 , 212-583-6000or business

1 a Gross receipts or sales

b Less returns and allowances c Balance

10

2 Cost of goods sold (Schedule A, line 7)

3 Gross profit Subtract line 2 from line ic

4 a Capital gain net income (attach Schedule D)

b Net gain (loss) (Form 4797, Part II, line 17) (attach Form 4797) ...............o Capital loss deduction for trusts

5 Income (loss) from partnerships and S corporations (attach statement)6 Rent Income (Schedule C)

7 Unrelated debt-financed income (Schedule E)

8 Interest, annuities, royalties, and rents from controlled organizations (Sch. F),.,9 Investment income of a section 501(c)(7), (9), or (17) organization

(Schedule G)

910 Exploited exempt activity income (Schedule I)

11 Advertising income (Schedule J)12 Other income (see instructions; attach statement)

13 Total. Combine lines 3through 12......................................................... 1 13 1<1,264,174.I>Part Ill Deductions Not Taken Elsewhere (see instructions for limitations on deductions)

(except for contributions, deductions must be directly connected with the unrelated business income)

141516

17

18

19

2021

22

2324

2526

2728

29

30

3132

33

34

Compensation of officers, directors, and trustees (Schedule K)

Salaries and wagesRepairs and maintenance

Bad debts

Interest (attach statement)

Taxes and licensesCharitable contributions (see instructions for limitation rules)

Depreciation (attach Form 4562) .21

Less depreciation claimed on Schedule A and elsewhere on return .22a

DepletionContributions to deferred compensation plans

Employee benefit programsExcessexempt expenses (Schedule I) ........................................................................................................................Excess readership costs (Schedule J) ........................................................................................................................Other deductions (attach statement) ...........................................................................................................................

Total deductions. Add lines 14 through 28

Unrelated business taxable income before net operating loss deduction. Subtract line 29 from line 13 . ...................................

Net operating loss deduction (limited to the amount on line 30) SAE S.T.TE.ME

Unrelated business taxable income before specific deduction. Subtract line 31 from line 30 ...........................................

Specific deduction (generally $1,000, but see instructions for exceptions)

Unrelated business taxable Income. Subtract line 33 from line 32. If line 33 is greater than line 32, enter the smallerof zero or line 32

22370101-11-13 LI-IA For Paperwork Reduction Act Notice, see instructions.

22b

.>

1,264,174.

Form 990-T (2012)56


I//J)i$/ Oat

Preparer's signature

& COMPANY LLC

AUTHOR I ZED SIGNER the preparer shown below (see

Title instructions)? [] Yes 0 NDate Check if PTIN

self-employedIt

P00445956Firm's EIN 01, 1.3-

L&Fonnti904(2012) THE BLOOMBERG FAMILY FOUNDAT

INC

20-5602483 Page 2

35 Organizations taxable as corporations (see instructions for tax computation).

Controlled group members (sections 1561 and 1563) check here See instructions and:

a Enter your share of the $50,000,$25,000, and $9,925,000 taxable income brackets (in that order):

(1) 1$ I (2) 1$ I (8) 1$ Ib Enter organization's share of (1) Additional 5% tax (not more than $11,750) [$ I

(2) Additional 3% tax (not more than $100,000) Is Ic Income tax on the amount on line 34

36 Trusts taxable at trust rates (see instructions for tax computation). Income tax on the amount on line 34 from:

Tax rate schedule or Schedule (Form 1041)

37 Proxytax(see instructions)

38 Alternative minimum tax .............................................................................................................................

39 Total. Add lines 37 and 38 to line 35c or 36, whichever applies

Part IV I Tax and Payments40a Foreign tax credit (corporations attach Form 1118; trusts attach Form 1116)

T .!.b Other credits (see instructions) I. I; General business credit Attach Form 3800 .40c

If Credit for prior year minimum tax (attach Form 8801 or 8827) .40d

e Total credits. Add lines 40a through 40d

41 Subtract line 40e from line 39

42 Other taxes. Check if from: Form 4255 Form- 8611 c:i Form 8697:1-F,Form 8866 EJ Other (attach statement)

43 Total tax. Add lines 41 and 42

44a Payments: A2011 overpayment credited to2Ol2 .44a 225,000.b2012 estimated tax payments ...................................................................................._________________

c Tax deposited with Form 8868 .....44c

d Foreign organizations: Tax paid or withheld at source (see instructions)

e Backup withholding (see instructions)

J44g

44e

Credit for small employer health insurance premiums (Attach Form 8941)

g Other credits and payments: Form 2439

Form 4136 EJ Other ___________________ Total

45 Total payments. Add lines 44a through 44g

46 Estimated tax penalty (see instructions). Check if Form 2220 is attached

47 Tax due, if line 45 is less than the total of lines 43 and 46, enter amount owed

48 Overpayment. If line 45 is larger than the total of lines 43 and 46, enter amount overpaid

49 Enter the amount of line 48 you want Credited to 2013 estimated tax 225 , 00 0 .1 Refunded

Part V I Statements Regarding Certain Activities and Other Information (see instructions)

35c1 0.

36

451 225.000.

At anytime during the 2012 calendar year, did the organization have an interest in or a signature or other authority over a financial account (bank,

securities, or other) in a foreign country? If 'Yes," the organization may have to file Form TO F 90-22.1, Report of Foreign Bank and Financial

Accounts. It 'Yes,' enter the name of the foreign country here 0,VARIOUSOUSDuring the tax year, did the organization receive a distribution from, or was It the Wanton 01, or translerar 10, it IoreIgl trust?If Yes" see Instructions for other forms the organization may have to file. ..................................................................................................................

Enter the amount of tax-exempt interest received or accrued during the tax year No.$iedule A - Cost of Goods Sold. Enter method of inventory valuation bo. N/A

1 Inventory at beginning of year 1 6 Inventory at end of year .6

2 Purchases 2 7 Cost of goods sold. Subtract line 6

3 Cost of labor 3 from line 5. Enter here and in Part I, line 2 7

4 a Additional section 263A costs (att. statement) 4a 8 Do the rules of section 263A (with respect to

b Other costs (attach statement) .4b property produced or acquired for resale) apply to

5 Total. Add lines 1 through 4b 5 the organizationUnder penalties of perjury, I declare that I have examined this return, Including accompanying schedules and statements, and to the best of my knowledg

Sign correct, and complete. Declaration of preparer (other than taxpayer) Is based on all Information of which preparer has any knowledge.

Here

Print/Type preparer's name

PaidCHARLES POMOPreparer

Use Only Firms name ' GELL

Firm's address no. 212-583-6000223711 01-11-13

Form 990-T (2012)

2

3

(es No

X

No

and belief, it Is true,


[A

RlForm 8868(Rev. January 2013)Department of the Treasuryinternal Revenue Service


File a separate application for each return.

OMB No. 1545-1709

• If you are filing for an Automatic 3-Month Extension, complete only Part land check this box• It you are filing for an Additional (Not Automatic) 3-Month Extension, complete only Part II (on page 2 of this form).

Do not complete Part // unless you have already been granted an automatic 3-month extension on a previously filed Form 8868.Electronic filing (e-file) . You can electronically file Form 8868 If you need a 3-month automatic extension of time to file (6 months for a corporationrequired to file Form 990-1), or an additional (not automatic) 3-month extension of time. You can electronically file Form 8868 to request an extensionof time to file any of the forms listed in Part I or Part II with the exception of Form 8870, Information Return for Transfers Associated With Certain

Personal Benefit Contracts, which must be sent to the IRS in paper format (see instructions). For more details on the electronic filing of this form,visft wwwirs.gov/efile and click one-file for Chant/es & Nonprofits.

Automatic 3-M

of Time.A corporation required to file Form 990T and requesting an automatic 6-month extension - check this box and completePart lonlyAil other corpo,ations (including 1120-C filers), partnerships, REM/Cs, and trusts must use Form 7004 to request an extension of timeto file income tax returns.

Type orprint

File by thedue date forfiling yourreturn. Seeinstructions.

Name of exempt organization or other filer, see instructions.

THE BLOOMBERG FAMILY FOUNDATION INCNumber, street, and room or suite no. If a P.O. box, see instructions.C/O GELLER & CO, 909 THIRD AVE. NO. 16 FLCity, town or post office, state, and ZIP code. For a foreign address, see instructions.NEW YORK, NY 10022 -



Enter the Return cede for the return that this application is for (file a separate application for each return) I 0 I 71

Application Return Application ReturnCode Is For Code

Form 990 or I

01 Form 990-T(Form 990-SL

02 Form 1041-A 0803 Form 4720 09

Form 990-PF

04 1 Form 5227Form 990-T (sec. 401(a) or 4

05 Form 6069 11

Form 990-T (trust other than 06 Form 8870

12

• The books are in the care of 909 THIRD AVENUE, 16TH FL - NEW YORK, NY 10022Telept-ioneNo.. 212583-6000 FAXNo..- 2125836241

• If the organization does not have an office or place of business in the United States, check this box• If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN) . If this is for the whole group, check thisbox . If it is for part of the group, check this box and attach a list with the names and EIN5 of all members the extension is for.

1 I request an automatic 3-month (6 months for a corporation required to file Form 990-1) extension of time untilNOVEMBER 15, 2013 ,to file the exempt organization return for the organization named above. The extension

is for the organization's return for.I calendar year 2012 orL] tax year beginning , and ending

2 If the tax year entered in line 1 is for less than 12 months, check reason: ED Initial return El Final return[J Change in accounting period

3a If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less anynonrefundable credits. See instructions. 3a

b If this application is for Form 990-PF, 990-T, 4720, or 6069, enter any refundable credits andestimated tax payments made. Include any prior year overpayment allowed as a credit. 3b

C Balance due. Subtract line 3b from line 3a. Include your payment with this form, If required,

Li,

225,000.

by using EFTPS (Electronic Federal Tax Pa yment System). See Instructions. I 3c I $ 0Caution. If you are going to make an electronic fund withdrawal with this Form 8868, see Form 8453 .E0 and Form 8879-EQ for payment instructions.

LI-IA For Privacy Act and Paperwork Reduction Act Notice, see instructions. Form 8868 (Rev. 1-2013)

22384101-21-13


19)12)THE BLOOMBERG FAMILY

ION INC

20-5602483 Paue 3C - Rent Income (From Real Prop

1. Description of property

2. Rent received or accrued

From personal property (it the percentage of I (b) From real end personal property f the percentage 3(a) Deductions directly connected with the income in

rent for personal property is more then of rent for personal property exceeds 50% or itcolumns 2(s) and 2(b) (attach statement)

10% but not more than 50%) I the rent is based on profit or Income)

Total 0 • I Total

(C) Total income. Add totals of columns 2(a) and 2(b). Enter

here and on page 1, Part I, line 6, column (A)

Schedule E - Unrelated Debt-Financed Income

1. Description of debt-financed property

(b)Total deductions.Enter here and on page 1,

0 . JPart l. line 6. column (B) 0ictions)

3. Deductions directly connected with or allocable2. Gross Income from I to debt-financed property

or allocable to debt- I (a) Straight line depreciation I (b) Other deductionsfinanced property (attach statement) I (attach statement)

4, Amount of average acquisitIon 5. Average adjusted basis 6. Column 4 divided 7. Gross Income 8. Allocable deductionsdebt on or allocable to debt-tinanced of or allocable to by column 5 reportable (column (column 6 total of columns

property (attach statement) debt-financed property 2 x column 6) 3(a) and 3(b))(attach statement)

(1)

(2)

(3) ¼

(4)

Enter here and on page 1, Enter here and on page 1,

Part I, line 7, column (A). Part I, tee 7, column (B).

Totals .................................................................................0. 0.Total dividends-received deductions included in column 8 0ichedule F - Interest, Annuities, Royalties, and Rents From Controlled Organizations (see instructions)

Exempt Controlled Organizations

1. Name of controlled organization 2. 3.4. 5. Part of column 4 that is 6. Deductions directlyEmployer identification Net unrelated Income Total of specified Included In the controtling connected with Income

number (loss) (see Instructions) I payments made organization's gross Income in columns

ompt Controlled Organizations

7. Taxable Income 8. Net Unrelated income (loss) 9. Total of specified payments 10. Part of column 9 that is included 11. Deductions directly connected

(see Instructions) made In the controlling organization's with Income in column 10gross Income

Add columns 5 and 10. Add columns Sand it

Enter here and on page 1, Part I, Enter here and on page 1, Part I,line 8, column (A). line 8, column (B).

Totals ..........................................................................................................................0. 0.223721 01-11-13 Form 990.1(2012)


6. Expensesattributable to

column 5

7. Excess exemptexpenses (column6 minus column 5,but not more than

column 4).

V VForm990-T(2012) THE BL100MBERG FAMILY FOUNDATION INC 205602483 Page 4Schedule G - Investment Income of a Section 501(c)(7),(9), or (17) Organization

(see instructions)3. Deductions

1. Description of Income 2. Amount of income I directly connected 4. Set-asides 5. Total et-asides

deductionsand S

- (attach statement) L_(A statement)

1

- (°• plus cot. 4)

rhere and onpage 1.I, line 9, column (B).

0.

I Enterhere anti on page 1,

I Patti, toeS, column (A)

Totals .....................................................0.j

Schedule I - Exploited Exempt Activity Income, Other Than Advertising Income(see instructions)

2. Gross I . Expenses4. Net income (toss)

directly connected from unrelated trade or 5. Gross IncomeDescription of unrelated business business (column 2 from activity that

Income from with production minus column 3). If a to not unrelatedI

exploded activityy

business income gain, compute cots. 5 business inthrough 7.

cometrade or business of unrelated

(1)

Enter here andon page 1,

Part II, line 26.

0.

Enter here and onpage 1, Part I,

tine 10, col. (A).

ota)s 0.Schedule J - Advertising Income (seePart I I Income From Periodicals Re

nter here and onpage 1, Part I,

line 10, cot. (B).

0.

on a

4. Advertising gain 7. Excess readership2. Gross 3. Direct or (loss) (cot. 2 minus 5. Circulation 6. Readership costs (column 6 minus

1. Name of periodical advertising advertising costs cot. 3). Ifs gain, compute Income costs column 5, but not moreincome cots. 5 through 7. than column 4).

(2)(3)

(4) J 0 .Totals (cai'ryto Part II, line (5)) 0. 0.I Part II I Income From Periodicals Reported on a Separate Basis (For each periodical listed in Part II, fill in

columns 2 through 7 on a line-by-line basis.

4. Advertising gain I I I i. Excess readership2. Gross 3. Direct or (loss) (Cot. 2 minus I 5. Circulutton I 6. Readership I costs (columnS minus1. Name of advertisings

I

dvesiog costs ccl. 3). if a gain, compute I income coats I column 5, but not moreincome cola. 5 through 7. I i I than column 4).

Totals from Part I

Part I) (lines 1-5)dule K - Compensat

1. Name

•, .

inter here and on Enter hare and onpage 1, Part I, page 1, Part

line it, cot. (A). line ii, cot. (B).

0. 0.istees (see Instructions)

3 Percent of

2. TItle time denoted tobusiness

on page 1,Pail II, tine 27.

0.

4. Compensation attributableto unrelated business

Total. Enter here and on page 1, Part Ii, line 14 I U

Form 990-T (2012)22373101-11-13

5917171111 737725 BLOOMFAMFND 2012.04040 THE BIJOOMBERG FAMILY FOUNDA BLOOMFA2

LOSSREMAINING

0.334,434.

1,670,140.

2,004,574.

AVAILABLETHIS YEAR

0.334,434.

1,670,140.

2,004,574.

TIRE BLOONBERG FAMILY (JNDATION INC 20-5602483

FORM 990-T INCOME (LOSS) FROM PARTNERSHIPS STATEMENT 18

DESCRIPTION

AMOUNT

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC

<2,007,762.>WILiLETT SELECT INVESTORS (TAX EXEMPT) I LP

363,154.

TOTAL TO FORM 990-T, PAGE 1, LINE 5

<1,644,608.>

FORM 990-P NET OPERATING LOSS DEDUCTION STATEMENT 19

LOSSPREVIOUSLY

TAX YEAR LOSS SUSTAINED APPLIED

12/31/08 186,525. 186,525.12/31/09 613,334. 278,900.12/31/10 1,670,140. 0.

NOli CARRYOVER AVAILABLE THIS YEAR

60 STATEMENT(S) 18, 1917171111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

Attach to Form 1120, 11120-ND, 1120-13C, 1120-PInformation about Schedule D

SCHEDULE D(Form 1120)Department of the Treasury

Internal Revenue Service

Name

Gains and Losses120-F, 1120-FSC, 1120-H, 1120-IC-D•REIT1120-RIC, 1120-SF, or certain0) and'its se p arate Instructions Is atwww.

OMB No. 1545-0123

l

ns 990-T. Iiv/formlllO. 2012

I Employer identification number

THE

FAMILY FOUNDATI

0-5602483I Part I I snort- I erm capitai uains ana Losses - Assets iieia une Year or tess

ompiete Form 8949 before completing line 1,d) PIOCendS (sales price) (e) Cost or other basis from (g) Adjustments to gainor 3. This form may be easier to complete If you from Form(s) 8949, Part I, Form(s) 8949, Part I, or toss from Form(s) 8949,round off cents to whole dollars. line 2, column (d) tine 2. column (e) Part I, line 2, column (g)

1 Short-term totals from all Forms 8949 with

box A checked in Part I


box B checked in Part I


box C checked in Part I

4 Short-term capital gain from installment sales from Form 6252, line 26 or 37

5 Short-term capital gain or (loss) from like-kind exchanges from Form 8824

6 Unused capital loss carryover (attach computation) .................................... ...............SEE STATEMENT 207 Net short-term capital gain or (loss). Combine lines 1 through 6 in column h

I Part II I Long.-Term Capital Gains and Losses - Assets Held More Than One Year

Complete Form 8949 bfore completing line Id) Proceeds(sales price) (e) Cost or other basIs from (9) Adjustments to gainor 10. This form maybe easier to complete if YOU from Form(s) 8949, Pert ii, Form(s) 8949, Part II, or loss from Form(s) 8949,round off cents to whole dollars. line 4, column (d) - line 4, column (e) Part ii, line 4, column (g)

8 Long-term totals from all Forms 8949 with

box A checked in Part II ................... ____________________________

9 Long-term totals from all Forms 8949 with

box B checkedinPart II ........................ ______________________

10 Long-term totals from all Forms 8949w,

box C checked in Part II ................... ____________________________

11 Enter gain from Form 4797, line 7 or 9 .-

12 Long-term capital gain from installment sales from Form 6252, line 26 or 37 .-

13 Long-term capital gain or (loss) from like-kind exchanges from Form 8824 .-

14 Capital gain distributions

15 Net long-term capital gain or (loss). Combine lines 8 through 14 In column h ___________________________________________________________________-

Part Ill I Summary of Parts I and II -16 Enter excess of net short-term capital gain (line 7) over net long-term capital loss (line 15)

17 Net capital gain. Enter excess of net long-term capital gain (line 15) over net short-term capital loss (line 7)

18 Add lines 16 and 17. Enter here and on Form 1120, page 1, line 8, or the proper line on other returns

Note. If losses exceed gains, see Capital losses in the instructions.

Gain or doss). Subtractin (e) from column (d) and

the result with column (g)

1,119,815.

Gain or doss). Subtractn (e) from column (d) and

the result with column (g)

JWA For Paperwork Reduction Act Notice, see the Instructions for Form 1120. Schedule D (Form 1120) (2012)

22105201-03-13

6117171111 737725 BLOONFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

EASales and Other Dispositions of Capital Assets

Information about Form 8949 and its separate instructions is at www.irs.gov1form8949.File with yourSchedule D to list your transactions for lines 1,2,3,8,9, and 10 of Schedule D.

OMB No. 1 5450074

2012AttachmentSequence No.l 2A

8949Department of thaTreasuryInternal Revenue Service

Name(s) shown on return

Social security number or(taxpayer identification no.

THE BLOOMBERG FAMILY FOUNDATION INC I 20-5602483Most brokers Issue their own substitute statement Instead of using Form 1099.8. They also may provide basis information (usually your cost) to you on the statement even If it is not reported to the IRS.Before you check Box A B, or C below, determine whether you received any statement(s) and, If so, the transactions for which basis was reported to the IRS. Brokers are required to report basis to theIRS for most stock you bought In 2011 or later.

Part I I Short-Term. Transactions Involving capital assets you held one year or less are short-term. For long-tern' transactions, see page 2.

You must check Box A, B, or C below. Check only one box. If more than one box applies for your short-term transactions, complete a separate Form8949, page 1, for each applicable box. If you have more short-term transactions than will fit on this page for one or more of the boxes, complete asmany forms with the same box checked as you need.

E (A) Short-term transactions reported on Form(s) 1099-B showing basis was reported to the IRS[XI (B) Short-term transactions reported on Form(s) 1099-8 showing basis was not reported to the IRS

(C) Short-term transactions not reported to you on Form 1099-B(a) (b) (c) (d) (e} Adjustment, if any, to gain or (h)I loss. If you enter an amount

Description of property Date acquired Date sold or ProceedsCost or other in column (g\ enter a code in Gain or (loss).

(Example: 100 sh. XYZ Co.) (Mo., day, yr.) disposed (sales price) basis. See the column . ee instructions. Subtract column (e)Note below andfrom column (d) and(Mo., day, yr.)see Column (e) in (1) I (g) of

combine the result

the instructions Cede(s) ijustment with column (g)

FROM K—i - WILLET'] I

1,115 42O.

2 Totals. Add the amounts in columns (d), (e), (g) and (h) (subtrainegative amounts). Enter each total here and include on yourSchedule D, line 1 (if Box A above is checked), line 2 (if Box B

is

C 1,119,815.

Note. If you checked Box A above but the basis reported to the IRS was incorrect, enter in column (e) the basis as reported to the IRS, and enter anadjustment in column (a) to correct the basis. See Column (g) in the separate instructions for how to figure the amount of the adjustment.223011 01-02-13 LHA For Paperwork Reduction Act Notice, see separate Instructions. Form 8949 (2012)


H111

^1Form 2220Department of the Treasuryinternal Revenue Service

Underpayment of Estimated Tax by CorporationsAttach to the corporation's tax return. FORM 990-P

Information about Form 2220 and its se parate instructions is atwww.lrs.aov/form222O.

OMB No. 1545-0142

2012Name

Employer identification number

THE BLOOMBERG FAMILY FOUNDATION INC

20-5602483Note: Generally, the corporation is not required to file Form 2220 (see Part II below for exceptions) because the IRS will figure any penalty owed and bill the

corporation. However, the corporation may still use Form 2220 to figure the penalty. If so, enter the amount from page 2, line 38 on the estimated taxpenalty line of the corporations income tax return, but do not attach Form 2220.

1 Total tax (see Instructions) ...................................................................................................................

2 a Personal holding company tax (Schedule PH (Form 1120), line 26) included on line 1

2a

b Look-back interest included on line 1 under section 460(b)(2) for completed long-term

contracts or section 167(g) for depreciation under the income forecast method

2b

o Credit for federal tax paid on fuels (see instructions) ............................................2c Id Total. Add lines 2a through 2c .....................................................................................................................2d

Subtract line 2d from line 1. If the result is less than $500, do not complete or file this form. The corporation

does not owe the penalty ........................................................................................................................................3

Enter the tax shown on the corporations 2011 income tax return (see instructions). Caution: If the tax is zero

or the tax year was for less than 12 months, skip this line and enter the amountfrom line 3 on line 5 .4

5 Required annual payment. Enter the smaller of line 3 or line 4. If the corporation is required to skip line 4,

I Part III Reasons for Filing . Check the boxes below that apply. If any boxes are checked, the corporation mustfile Form 2220even if ft does not owe a penalty (see instructions).

6 L.....J The corporation is using the adjusted seasonal Installment method.

7 El The corporation is using the annualized income installment method.

8 LIJ The corporation is large corporation figuring its first required installment based on the prior years tax.

9 Installment due dates. Enter in columns (a) through(d) the 15th day of the 4th (Form 990-PF filers:Use 5th month), 6th, 9th, and 12th months of thecorporation's tax year ................................................

10 Required installments, lithe box on line 6 and/or line 7

above is checked, enter the amounts from Sch A, line 38. If

the box on line 8 (but not 6 or 7) is checked, see instructions

for the amounts to enter. If none of these boxes are checked,

enter 25% of line 5 above in each column.

11 Estimated tax paid or credited for each period (see

instructions). For column (a) only, enter the amount

from line 11 on line 15

Complete lines 12 through 18 of one column before

going to the next column.

12 Enter amount, if any, from line 18 of the preceding column

13 Add lines 11 and 12

14 Add amounts on lines 16 and 17 of the preceding column

15 Subtract line 14 from line 13. If zero or less, enter -0-

16 If the amount on line 15 is zero, subtract line 13 from line

14. Otherwise, enter -0-

17 Underpayment. If line 15 Is less than or equal to line 10,

subtract line 15 from line 10. Then go to line 12 of the next

column. Otherwise, go to line 18 .................................

18 Overpayment. If line 10 is less than line 15, subtract line 10

from line 15. Then co to line 12 of the next column .........

Go to Part IV an page 2 to figure the penalty. Do not go to Part IV if there are no entries on line 17-no penalty is owed.

JWA For Paperwork Reduction Act Notice, see separate instructions. Form 2220(2012)

21250112-11-12

11

12

13

14

15

16

17

18

62.117171111 737725 BLOOMFNFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

FORM 990-PForm 2220 (2012) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Page 2

I Part IV I Figuring the Penalty

19 Enter the date of payment or the 15th day of the 3rd month

after the close of the tax year, whichever is earlier (see

instructions). (Form 990-PF and Form 990-1 filers: Use 5th

month instead of 3rd month.) .19

20 Number of days from due date of installment online 9 to the

date shown on One l9 .................................................... 20

21 Number of days online 20 after 4/15/2012 and before 7/1/2012 ......

22 Underpayment on line 170 Number of days online 21 x3%366

23 Number of days online 20 after 06/30/2012 and before 10/1/2012 ..

24 Underpayment on line 17 x Number of days on line 23 x 3% 24Mr—

25 Number of days on line 20 after 913012012 and before 1/1/2013 I 25

26 Underpayment online 170 Number of days online 25x 3%366

27 Number of days online 20 after 12/31/2012 and before 411/2013 127

28 Underpayment on One 17 tc Number of days on line 27 x 3%3b5

29 Number of days online 20 after 3/3lf2Ol3 and baforo7/1/2013 I 29

30 Underpayment on line 17x Number of days online 29 x % .303b5

31 Number of days online 20 after 6/30/2ol3 and before 10/0112013 131

32 Underpayment online 170 Number of days online 31 x % .32365

33 Number of days online 20 after 9/30/2013 and before 111/2014 ......

34 Underpayment on line 17 x Number of days on line 33x %365

35 Number of days online 20 after 12/31/2013 and before 2/16/2014 135

36 Underpayment online 170 Number of days online 35 x % ......... .36365

37 Add lines 22. 24, 26, 28. 30, 32, 34, and 36 LZ

38 Penalty. Add columns (a) through (d) of line 37. Enter the total here and on Form 1120; line 33;

or the comparable line for other income tax returns

0.* Use the penalty interest rate for each calendar quarter, which the IRS will determine during the first month in the preceding quarter.These rates are published quarterly in an IRS News Release and in a revenue ruling in the Internal Revenue Bulletin. To obtain thisinformation on the Internet, access the IRS website at wwwirs.gov. You can also call 1-800-829-4933 to get interest rate Information.

JWA Form 2220 (2012)

21280212-11-12

62.217171111 737725 BLOOMFAMFND 2012.04040 THE ELOOMBERG FAMILY FO1JNDA BLOOMFA2

THE BLOOMBERG FAMILY WUNDATION INC 20-5602483

SCHEDULE D CAPITAL LOSS CARRYOVER STATEMENT 20

LOSSORIGINAL

PREVIOUSLY

LOSSLOSS YEAR

LOSS SUSTAINED

APPLIED

REMAINING

20072008

810,286

76,316

733,9702009

5,411

5,41120102011

CAPITAL LOSS CARRYOVER TO CURRENT TAXABLE YEAR

739,381


S

SN*

EfForm 86211 Information Return by a Shareholder of a Passive Foi(Rev.December2Ol2) Investment Company or Qualified Electing FundDepartment of the Treasury IInte,nai Revenue Service Information about Form 8621 and its se parate instructions is at ,..... ;.... ;....o.',. -

OMB No. 1546-1002

Attachment -Sequence No. 69

Name of shareholder

THE BLOOMBERG FAMILY FOUNDATION INCNumber, street, and room or suite no. (If a P.O. box, see instructions.)

C/O GELLER & CO. 909 THIRD AVE. NO. 16 FLCity or town, state, and ZIP code or country

NEW YORK, NY 10022

Identifying number (see instructions)

20-5602483Shareholder tax year calendar year U 1 2 or other tax year beginning

Check type of shareholder filing the return: L....J Individual LJ Corporation L.....J Partnership L......J S Corporation L......J NongranName of passive foreign investment company (PFIC) or qualified electing fund (QEF) Employer identification number (if any)ALPST.AR CLO 2 P.L.C.

Address (Enter number, street, city or town, and country.) Reference ID number (see instructions)5 HARBOURMASTER PLACE, INT'L FIN SVC CTRDUBLIN 1, IRELAND Tax year of PFIC or QEF: calendar year

tax year beginning

endingPart I Summary of Annual Information Part I is reserved for future use (see instructions).

Provide the following information with respect to all shares of the PFIC held by the shareholder:

1 Description of each class of shares held by the shareholder:

F Check if shares jointly owned with spouse.

2 Date shares acquired during the taxable year, if applicable:

3 Number of shares held at the end of the taxable year:

4 Value of shares held at the end of the taxable year (check the appropriate box, If applicable):

(a) LII $0-50,000 (b) EJ $50,001-100,000 (c) LI $100,001-150,000 (d) LI $150,001-200,000(e) If more than $200000, list value:

5 Type of PFIC and amount of any excess distribution or gain treated as an excess distribution under section 1291, inclusion under section

1293, or inclusion or deduction under section 1296:

(a) LI Section 1291 $________________________

(b)Section 1293 (Qualified Electing Fund) $________________________

(C) LI Section 1296 (Mark to Market) $________________________

or other

and

Part II Elections (See instructions.)A L.J Election To Treat the PFIC as a QEF. 1,0 shareholder of a PFIC, elect to treat the PFIC as a QEF. Complete lines 6a through 7c of Part II!.B LI Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits

of the QEF until this election is terminated. Completelines 8a through 9c of Part Ill to calculate the tax that may be deferred.Note: If any portion of line 6a or line 7a of Part

ill is includible under section 951, you may 0f make this election. Also, see sections

1294(c) and 1294(0 and the related regulations for events that terminate this election.C LI Election To Mark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect to mark-to-market the PFIC stock that is marketable within the meaning of section

1296(e). Complete Part IV.

D LI Deemed Sale Election. I, a shareholder on the first day of a PFICs first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in thePFIC.Entergain or loss online 15f of Part V.

E LI Deemed Dividend Election. I, a shareholder on the first day of a PFICs first tax year as a QEF that is controlled foreign corporation (CFC), elect to treat anamount equal to my share of the post-1986 earnings and profits of the CFC as an excess distribution. Enter this amount on line 15e of Part V. If theexcess distribution is greater than zero, also complete line 16 of Part V.

F LI Election To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, elect to treat as an excessdistribution the gain recognized on the deemed sale of my interest In the PFIC on the last day of its last tax year as a PAC under section 1297(a). Entergain on line 75f of Part V.

G ED 1.1297-3(a),Dividend Election With Respect to a Section 1297(e) PFIC. I, a shareholder of a section 1297(e) PFIC, within the meaning of Regulations section

1.1297.3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFIC. My holding period In the stock of the Section 1297(e)PFIC includes the CFC qualification date, as defined in Regulations section 1.1297-3(d). Enter the excess distribution online 15e, Part V. If the excessdistribution is greater than zero, also complete line 16, Part V.

H E:1 electDividend Election With Respect to a Former PFIC. I, a shareholder of a former PFIC, within the meaning of Regulations section 1.1298-3(a),

elect to make a deemed dividend election with respect to the former PFIC. My holding period in the stock of the former PFIC includes the termination date, asdefined in Regulations section 1.1298-3(d). Enter the excess distribution on line 15e, Part V. If the excess distribution is greater than zero, alsocomplete line 16, Part V.

01-2813 Ij-LA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 8621 (Rev. 12-2012)

Ei

EAForm 8621 (Rev. 12-2012) Page 2

Part III Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines Ba through 7c. If you are makingElection B, also complete lines Ba through 9c. (See instructions.)

6 a Enter your pro rata share of the ordinary earnings of the QEF I 68 IEnter the portion of line Ba that is included in income under section 951 or that may be

excluded under section 1293(g) I 6b ISubtract line 6b from line 6a. Enter this amount on your tax return as ordinary Income ...................................................

7 a Enter your pro rata share of the total net capital gain of the QEF I 7a Ib Enter the portion of line 7a that is included In income under section 951 or that may be

excluded under section 1293(g) I lb Io Subtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule D

used for your income tax return. (See instructions.)

8 Add lines 6c and 7c ..........................................................................................................................................b Enter the total amount of cash and the fair market value of other property distributed

or deemed distributed to you during the tax year of the QEF. (See instructions.) ._!!L.Enter the portion of line 8a not already included in line 8c that Is attributable to shares

in the QEF that you disposed of, pledged, or otherwise transferred during the tax year Bcd Add lines 8band Bc

e Subtract line 8d from line Ba, and enter the difference (if zero or less, enter amount in brackets)

Important:!! line Be is greater than zero, and no portion of line 6a or 7a is includible in income under sec tion 951,you may make Election B with respect to the amount online Be.

9 a Enter the total tax for the tax year (See Instructions.) ...2Lb Enter the total tax for the tax year determined without regard to the amount entered

on line 8e 9b

c Subtract line 9b from line 9a. This is the deferred tax, the time for payment of which Is extended by making

iecuun Is ...................................................................................................................................................... IPart IV Gain or (Loss) From Mark-to-Market Election (See instructions.) -

lOa Enter the fair market value of your PFIC stock at the end of the tax year ..........................................................................i!

b Enter your adjusted basis in the stock at the end of the tax year

c Subtract line lOb from line ba. If a gain, do not complete lines 11 and 12. Include this amount as ordinary income

on your tax return. If a loss, go to line 11 ._j.11 Enter any unreversed inclusions (as defined in section 1296(d)) .

.J!12 Enter the loss from line lOc, but only to the extent of unreversed inclusions on line 11. Include this amount as an ordinary

loss on your tax return 1213 If you sold or otherwise disposed of any section 1296 stock (see instructions) during the tax year

a Enter the fair market value of the stock on the date of sale or disposition

b Enter the adjusted basis of the stock on the date of sale or disposition .13bc Subtract line 13b from line 13a. If a gain, do not complete line 14. Include this amount as ordinary income on your

tax return. If a loss, go to line 14

14a Enter any unreversed inclusions (as defined in section 1296(d))

b Enter the loss from line 13c, but only to the extent of unreversed inclusions on line 14a. Include this amount as an ordinary

loss on your tax return. If the loss on line 13c exceeds unreversed inclusions on line 14a, complete line 14c .14bc Enter the amount by which the loss on line 13c exceeds unreversed inclusions on line 14a. Include this amount on your tax

return according to the rules generally applicable for losses provided elsewhere in the Code and regulations .Note. See instructions in case of multiple dispositions.

Form 8621 (Rev. 12-2012)

6c

7c

8d

21261201-29-13

LiS

Form 8621 (Rev. 12-2012) Page 3

Part V Distributions From and Dispositions of Stock of a Section 1291 Fund(See instructions.)Complete a Part Vfor each excess distribution (see instructions).

15 a Enter your total distributions from the section 1291 fund during the current tax year with respect to the applicable stock. If the

holding period of the stock began in the current tax year, see instructions

b Enter the total distributions (reduced by the portions of such distributions that were excess distributions but not

Included In income under section 1291(a)(1)(13)) made by the fund with respect to the applicable stock for each of the 3 years

preceding the current tax year (or if shorter, the portion of the shareholders holding period before the current tax year)

o Divide line 15b by 3. (See instructions if the number of preceding tax years is less than 3.)

d Multiply line 15c by 125% (1.25)

e Subtract line 15d from line 15a. This amount, if more than zero, is the excess distribution with respect to the applicable stock.

If zero or less and you did not dispose of stock during the tax year, do not complete the rest of Part V. See instructions if you

received more than one distribution during the current tax year. Also, see instructions for rules for reporting a nonexcessdistribution on your income tax return

I Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund. If a gain,

complete line 16. If a loss, show it in brackets and do not complete line 16

16 a Attach a statement for each distribution and disposition. Show your holding period for each share of stock

or block of shares held. Allocate the excess distribution to each day in your holding period. Add all amounts

that are allocated to days in each tax year.

b Enter the total of the amounts determined In line 16a that are allocable to the current tax year and tax years

before the foreign corporation became a PFIC (pre-PFIC tax years). Enter these amounts on your income tax

return as other income SEE STATEMENT 21o Enter the aggregate increases in tax (before credits) for each tax year In your holding period

(other than the current tax year and pre-PFIC years). (See instructions.)

d Foreign tax credit. (See instructions.)

e Subtract line 16d from line 16c. Enter this amount on your income tax return as 'additional tax? (See instructions.)

Determine interest on each net increase in tax determined on line 16e using the rates and methods of section 6621.

15a1 39,421.

15e

39,421.

151

16b1 39,421.

--I.. amount -----------------.--.- -----Liner me ayyiojte OIIIUUIIL lit IllWISt Here. iee IDSUUCUOflS.) .................................................................................... I 1611Part VI Status of Prior Year Section 1294 Elections and Termination of Section 1294 Elections

Complete a separate column for each outstanding election. Complete lines 25 and 26 only if there Is partial termination of the section1294 election.

17 Tax year of outstanding

election

18 Undistributed earnings to

which the election relates

19 Deferred tax

20 interest accrued on deferred

tax (tine 19) as of the filing date

21 Event terminating election

22 Earnings distributed or deemed

distributed during the tax year

23 Deferred tax due with this

return

24 Accrued interest due with

this return

25 Deferred tax outstanding after

Partial termination of election

26 Interest accrued after partial

termination of election ......

Form 8621 (Rev. 12-2012)

21261301-29-13

19Form 86211 Information Return by a Shareholder of a Passive Foreiglev.Dber 2a12) Investment Company or Qualified Electing FundDepaument of the Treasurytflte,n Revenue Service • Information about Form 8621 and Its separate Instructions Is at LVWW i,nnvIf,,mR21

OMB No, 1545.1002

AttachmentSequence No. 69

Name of shareholder

THE BLOOMBERG FAMILY FOUNDATION INCNumber, street and room or suite no. (If a P.O. box, see instructions.)

C/O GELLER & CO, 909 THIRD AVE. NO. 16 FLCity ortown, state, and ZIP code or countryNEW YORK, NY 10022Check

the return: LJ Individual

Name of passive foreign investment company (PFIC) or qualified electing fund (QEF)

CORDATUS CLO I P.L.C.

Address (Enter number, street, city or town, and country.)

5 HARBOURMASTER PLACE, INT'L FIN SVC CTRDUBLIN 1, IRELAND

i-'art I Summary of Annual Information Part I is reserved for IProvide the following information with respect to all shares of the PFIC held by the shareholder:

I Description of each class of shares held by the shareholder:El Check U shares Jointly owned with spouse.



4 Value of shares held at the end of the taxable year (check the appropriate box, if applicable):

(a) il $0-50,000 (b) i::i $50,001-100,000 (c) El $100,001-150,000(e) If more than $200,000, list value:

Identifying number (see Instructions)

20-5602483Shareholder tax year: calendar year2 0 1 2 or other tax year beginning

and ending

L_J S Corporation L.._J Non grantor Trust L.....J Estat

Employer identification number (if any)

Reference ID number (see instructions)

Tax year of PFIC or QEF: calendar year or othertax year beginning and

(d) El $150,001-200,000

5 Type of PFIC and amount of any excess distribution or gain treated as an excess distribution under section 1291, inclusion under section1293, or inclusion or deduction under section 1296:

(a) El Section 1291 $_______________________(b) El Section 1293 (Qualified Electing Fund) $_________________________

(C) El Section 1296 (Mark to Market) $

Part II Elections (See instructions.)

A Li Election To Treat the PFIC as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF. Complete fines Ga through 7c of Part Ill.B El Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits

of the QEF until this election is terminated. Complete lines Ba through 9c of Part Il/to calculate the tax that maybe deferred.Note: If any portion of fine Ga or line 7a of Part Ill is includible under section 951, you may 0f make this election. Also, see sections1294(c) and 1294(f) and the related regulations for events that terminate this election.

C El Election To Mark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect to mark-to-market the PFIC stock that is marketable within the meaning of section1296(e). Complete Part IV.

D El Deemed Sale Election. I, a shareholder on the first day of a PFICs first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in thePFIC. Enter gain or loss on fine 15f of Part V.

E El Deemed Dividend Election. I, a shareholder on the first day of a PFIC's first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat anamount equal to my share of the post-1986 earnings and profits of the CFO as an excess distribution. Enter this amount on fine 15e of Part V. If theexcess distribution is greater than zero, also complete line 16 of Part V.

F El Election To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, elect to treat as an excessdistribution the gain recognized on the deemed sale of my interest in the PFIC on the last day of its last tax year as a PFIC under section 1297(a). Entergain on fine 15f of Part V.

El Deemed Dividend Election With Respect to a Section 1297(e) PFIC. I, a shareholder of a section 1297(e) PFIC, within the meaning of Regulations sectionG1.1297-3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFIC. My holding period in the stock of the Section 1297(e)PFIC includes the CFC qualification date, as defined in Regulations section 1.1297-3(d). Enter the excess distribution on fine 15e, Part V. If the excessdistribution is greater than zero, also complete fine 16, Part V.

H El Deemed Dividend Election With Respect to a Former PFIC. I, a shareholder of a former PFIC, within the meaning of Regulations section 1.1298-3(a),elect to make a deemed dividend election with respect to the former PFIC. My holding period In the stock of the former PFIC includes the termination date, asdefined in Regulations section 1.1298-3(d). Enterthe excess distribution on line 15e, Part V. If the excess distribution isgreaterthan zero, alsocomplete fine 16, Part V.

01-29-13 Li-IA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 8621 (Rev. 12-2012)

Form 8621 (Rev. 122012) Page 2

Part Ill Income From a Qualified Electing Fund (QEF). All OF shareholders complete lines Ba through 7c. If you are makingElection B, also complete lines 8a through 9c. (See instructions.)

6 a Enter your pro rata share of the ordinary earnings of the aEF I 6a Ib Enter the portion of line 6a that is included in income under section 951 or that may be

excluded under section 1293(g) I 6b ISubtract line 6b from line 6a. Enter this amount on your tax return as ordinary income ...................................................

7 a Enter your pro rata share of the total net capital gain of the QEF .7a IEnter the portion of line 7a that Is included in income under section 951 or that may be

excluded under section 1293(g)[7b

C Subtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule D

used for your Income tax return. (See instructions.)

8 a Add lines 6c and 7c ..........................................................................................................................................b Enter the total amount of cash and the fair market value of other property distributed

or deemed distributed to you during the tax year of the QEF. (See instructions.) .8b

c Enter the portion of line Ba not already included In line 8c that is attributable to shares

in the QEF that you disposed of, pledged, or otherwise transferred during the tax year Bcd Add lines 8b and 8c

e Subtract line 8d from line Ba, and enter the difference (If zero or less, enter amount in brackets)

Important: If line 8e is greater than zero, and no portion of line Ga or 78 is includible In income under section 951,you may make Election B with respect to the amount on line Be.ga

9 a Enter the total tax for the tax year (See instructions.)

b Enter the total tax for the tax year determined without regard to the amount entered

on line Be 9b

c Subtract line 9b from line 9a. This Is the deterred tax, the time for payment of which is extended by making

or

ba Enter the fair market value of your PFIC stock at the end of the tax year


c Subtract line lOb from line lOa. If again, do not complete lines 11 and 12. Include this amount as ordinary income

on your tax return. If a loss, go to line 11

11 Enter any unreversed inclusions (as defined in section 1296(d))

12 Enter the loss from line lOc, but only to the extent of unreversed inclusions on line 11. Include this amount as an ordinary

loss on your tax return

13 It you sold or otherwise disposed of any section 1296 stock (see instructions) during the tax year

a Enter the fair market value of the stock on the date of sale or disposition .13ab Enter the adjusted basis of the stock on the date of sale or disposition .13bc Subtract line 13b from line 13a. It a gain, do not complete line 14. Include this amount as ordinary income on your

tax return. If a loss, go to line 14 130.

14a Enter any unreversed inclusions (as defined in section 1296(d)) .i


loss on your tax return. If the loss on line 13c exceeds unreversed inclusions on line 14a, complete line 14c

c Enter the amount by which the loss on line 13c exceeds unreversed inclusions on line 14a. Include this amount on your tax


Form 8621 (Rev. 12-2012)

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21261201-29-13

Form 8621 (Rev. 12-2012) Page 3

Part V Distributions From and Dispositions of Stock of a Section 1291 Fund (See instructions.)Complete aspoarat, Part Vfor each excess distribution (see Instructions).



b Enter the total distributions (reduced by the portions 01 such distributions that were excess distributions but not

included in income under section 1291(a)(1)(8)) made by the fund with respect to the applicable stock for each of the 3 years


Divide line 15b by 3. (See instructions if the number of preceding tax years is less than 3.)


Subtract line 15d from line 15a. This amount, if more than zero, is the excess distribution with respect to the applicable stock.


received more than one distribution during the current tax year. Also, see instructions for rules for reporting a nonexcess

distribution on your income tax return

Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund, If a gain,





b Enter the total of the amounts determined in line 16a that are allocable to the current tax year and tax years


return as other income SEE STATEMENT 22c Enter the aggregate increases In tax (before credits) for each tax year in your holding period



e Subtract line 16d from line 16c. Enter this amount on your income tax return as 'additional tax.' (See instructions.)

I Determine interest on each net increase in tax determined on line 16e using the rates and methods of section 6621.

Enter the aooreoate amount of Interest here. (See instriir.tinnn'i

Part VI Status of Prior Year Section 1294 Elections and Termination of Section

5

15b1 3,446.

1,431.

1511

1.

16c

Complete a separate column for each outstanding election. Complete fines 25 and 26 only if there is a partial termination of the section1294 election.


election



19 Deterred tax






return


this return


partial termination of election


Form 8621 (Rev. 12-2012)

21261301-29-13

17A

^1186211 Information Return by a Shareholder of a Passive Foreign

(Rev. Decem 12) Investment Company or Qualified Electing FundDepartment of the Treasury IIntetnat Revenue Service Information about Form 8621 and its separate instructions is at www irn nr,w1rnrmpp.1

OMB No. 1545-1002


Name of shareholder


C/O GELLER & CO. 909 THIRD AVE. NO. 16 FLCity or town, state, and ZIP code or country

NEW YORK, NY 10022Check type of shareholder filing the return: L.....J Individual


CAIRN CLO I BV


20-5602483Shareholder tax year: calendar year4 U 14 or other tax year beginning



P.ARNASSUSTRN, LOCATELLIKADE 11076 AZ AMSTERDAM, NETHERLANDS

of Annual


Tax year of PFIC or QEF: calendar year

tax year beginning

for

or other

and

Provide the following information with respect to all shares of the PFIC held by the shareholder.

1 Description of each class of shares held by the shareholder

Check if shares jointly owned with spouse.

2 Date shares acquired during the taxable year, If applicable:



(a) $0-50,000 (b) $50,001-100,000 (C) $100,001-150,000

(e) If more than $200,000, list value:(d) $150,001-200,000



(a) EJ Section 1291 $_________________________

(b)Section 1293 (Qualified Electing Fund) $_________________________(c) LII] Section 1296 (Mark to Market) $


A L.....] Election To Treat the PFIC as a DEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF. Complete lines 6a through 7c of Part ill.B LJ Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits

of the QEF until this election is terminated. Complete lines 8a through 9c of Part Ill to calculate the tax that may be deferred.Note: If any portion of line 6a or line 7a of Part 1/1 is includible under section 951, you maynot make this election. Also, see sections1294(c) and 1294(l) and the related regulations for events that terminate this election.

C Election To Mark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect to mark-to-market the PFIC stock that is marketable within the meaning of section1296(e). Complete Part /V.

D E1 Deemed Sale Election. I, a shareholder on the first day of a PFICs first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in thePFIC. Enter gain or loss online 15f of Part V.

E Deemed Dividend Election. I, a shareholder on the first day of a PFIC's first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat anamount equal to my share of the post-1986 earnings and profits of the CFC as an excess distribution. Enter this amount on line 15e of Part V. If theexcess distribution is greater than zero, also complete line 16 of Part V.

F Election To Recognize Gain an Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, elect to treat as an excessdistribution the gain recognized on the deemed sale of my Interest in the PF1C on the last day of its last tax year as a PFIC under section 1297(a). Entergain online 15f of Part V.

Deemed Dividend Election With Respect to a Section 1297(e) PFIC. I, a shareholder of a section 1297(e) PFIC, within the meaning of Regulations section1.1297-3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFIC. My holding period in the stock of the Section 1297(e)PFIC includes the CFC qualification date, as defined in Regulations section 1.1297-3(d). Enter the excess distribution online 15e, Part V. If the excessdistribution is greater than zero, also complete line 16, Part V.

H LII Deemed Dividend Election With Respect to a Former PFIC. I, a shareholder of a former PFIC, within the meaning of Regulations section 1.1298-3(a),elect to make a deemed dividend election with respect to the former PFIC. My holding period In the stock of the former PFIC includes the termination date, asdefined in Regulations section 1.1298-3(d). Enter the excess distribution on line 15e, Part V. If the excess distribution is greater than zero, alsocomplete line 16, Part V.

01-29-13 LI-IA For Disclosure, Privacy Act, and Paperwork Reduction Mt Notice, see separate instructions. Form 8621 (Rev. 12-2012)

t 0Form 8621 (Rev. 12-2012)

Page 2Part Ill Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines 6a through 7c. If you are making

Election B, also complete lines Ba through 9c. (See instructions.)

6 a Enter your pro rata share of the ordinary earnings of the QEF I 6a I -b Enter the portion of line 6a that Is Included in Income under section 951 or that may be


7 a Enter your pro rata share of the total net capital gain of the QEF I Tab Enter the portion of line 7a that is included In Income under section 951 or that may be

excluded under section 1293(g) I lb IC Subtract line lb from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule D


8 a Add lines 6c and 7c ..........................................................................................................................................

b Enter the total amount of cash and the fair market value of other property distributed


c Enter the portion of line Ba not already included in line Bc that is attributable to shares

in the QEF that you disposed of, pledged, or otherwise transferred during the tax year 8c

d Add lines 8b and 8c

e Subtract line Sd from line Be, and enter the difference (if zero or less, enter amount in brackets)

Important: If line Be is greater than zero, and no portion of fine Ba or 7a is includible in income under section 951,you may make Election B with respect to the amount online Be.

9 a Enter the total tax for the tax year (See Instructions.) .99


on line 8e .9b

Subtract line 9b from line 9a. This is the deferred tax, the time for payment of which is extended by making

Election B

I IV Gain or (Loss) From Mark-to-Market Election (See instructions.'iDa Enter the fair market value of your PFIC stock at the end of the tax year iDa

b Enter your adjusted basis in the stock at the end of the tax year lobo Subtract line lOb from line lOa. If a gain, do not complete lines 11 and 12. Include this amount as ordinary income

on your tax return. If a loss, go to line 11 1001111 Enter any unreversed inclusions (as defined in section 1296(d)) .

12 Enter the loss from line bc, but only to the extent of unreversed Inclusions on line 11. Include this amount as an ordinary

losson your tax return ......................................................................................................................................._________________________

13 If you sold or otherwise disposed of any section 1296 stock (see instructions) during the tax year:

a Enter the fair market value of the stock on the date of sale or disposition .13ab Enter the adjusted basis of the stock on the date of sale or disposition .

c Subtract line 13b from line 13a. If a gain, do not complete line 14. Include this amount as ordinary Income on your

tax return. If a loss, go to line 14 .t3c14a Enter any unreversed inclusions (as defined in section 1296(d))


loss on your tax return. If the loss on line 13c exceeds unreversed Inclusions on line 14a, complete line 14c .14bc Enter the amount by which the loss on line 13c exceeds unreversed inclusions on line 14a. Include this amount on your tax

return according to the rules generally applicable for losses provided elsewhere in the Code and regulations .14cNote. See instructions in case of multiple dispositions.

Form 8621 (Rev. 12-2012)

8d

21261201-29-13

Form 8621 (Rev. 12-2012) Page 3

Part V Distributions From and Dispositions of Stock of a Section 1291 Fund(See instructions.)Complete a ,12arat,.Part V for each excess distribution (see instructions).


holding period of the stock began In the current tax year, see instructions

Enter the total distributions (reduced by the portions of such distributions that were excess distributions but not

included in Income under section 1291(a)(1)(13)) made by the fund with respect to the applicable stock for each of the 3 years

preceding the current tax year (or if shorter, the portion of the shareholder's holding period before the current tax year)


Multiply line 15c by 125% (1.25)



received more than one distribution during the currenttax year. Also, see instructions for rules for reporting a nonexcess


Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund. If a gain,







return as other income SEE STATEMENT 23Enter the aggregate increases in tax (before credits) for each tax year in your holding period



e Subtract line 16d from line 16c. Enter this amount on your income tax return as 'additional tax.' (See Instructions.)

Determine interest on each net increase in tax determined on line 16e using the rates and methods of section 6621.4.. .....III...• —' _4--II--

Luiwi e UyIO--yaLO OUUIII UI tIIW--lO-- -1----

010. fee IHSUUCIIUflS.) ....................... ............................................................. I 16f IPart VI Status of Prior Year Section 1294 Elections and Termination of Section 1294 Elections

Complete a separate column for each outstanding election. Complete lines 25 and 26 only if there is partial termination of the section1294 election.


election



20 Interest accrued on deferred



return

24 Accrued Interest due with

this return





Form 8621 (Rev. 12-2012)

152 2,780.

15b 2,403.

15e1 1,277.

16b

1,277.

16c

21261301-29-13

86211 Information Return by a Shareholder of a Passive Foi(Rev.Decembe2012) I Investment Company or Qualified Electing FundDepartment of the TreasuryInternal Revenue Service • Information about Form 8621 and its se p arate instructions is at

OMB No. 1545-1002


Name of shareholder

THE BLOONBERG FAMILY FOUNDATION INCNumber, street, and room or suite no. (if a P.O. box, see instructions.)

C/O GELLER & CO, 909 THIRD AVE. NO. 16 FLCityor town, state, and ZIP code or country

NEW YORK, NY 10022Check type of shareholder filing the return: L.....J Individual L.J Corporation


CAIRN CLO II BV


20-5602483

Shareholder tax year. calendar year2 U 1 4 or Other tax year beginning

and ending

L._J S Corporation Liii Nongrantor Trust L.....J Estat


Address (Enter number, street, city or town, and country.) Reference ID number (see instructions)

PARNASSUSTRN I LOCATELLIKADE 11076 AZ AMSTERDAM, NETHERLANDS Tax year of PFIC or QEF: calendar year

tax year beginning

ending

Part I Summary of Annual Information Part I is reserved for future use (see instructions).




2 Date shares acquired during the taxable year, If applicable:



(a) E $0-50,000 (b) $50,001-100,000 iiiii $100,001-150,000 ((I) c:ii $150,001-200,000

(e) If more than $200,000, list value:



(a) Section 1291 $________________________

(b) LIII Section 1293 (Qualified Electing Fund) $________________________

(C) Lii Section 1296 (Mark to Market) $________________________

or other

and


A L.....J Election To Treat the PFIC as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF. Complete lines Ga through 7c of Part Ill.B Lii Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits

of the QEF until this election is terminated. Complete lines 8a through 9c of Part lii to calculate the tax that maybe deferred.Note: If any portion of line 6a or line 7a of Part Ill is includible under section 951, you maynot make this election. Also, see sections1294(c) and 1294(f) and the related regulations for events that terminate this election.

C E Election To Mark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect to mark-to-market the PFIC stock that is marketable within the meaning of section


D LIII Deemed Sale Election. I, a shareholder on the first day of a PFIC's first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in the

PFIC. Enter gain or loss on line 15f of Part V.

E Deemed Dividend Election. I, a shareholder on the first day of a PFICs first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat anamount equal to my share of the post-1986 earnings and profits of the CFC as an excess distribution. Enter this amount on line 15e of Part V. If theexcess distribution is greater than zero, also complete line 16 of Part V.

F LJ Election To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, elect to treat as an excessdistribution the gain recognized on the deemed sale of my interest in the PFIC on the last day of its last tax year as a PFIC under section 1297(a). Entergain on line 15f of Part V.

G Deemed Dividend Election With Respect to a Section 1297(0) PFIC. I, a shareholder of a section 1297(e) PFIC, within the meaning of Regulations section1.1297-3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFIC. My holding period in the stock of the Section 1297(e)PF1C includes the CFC qualification date, as defined in Regulations section 1.1297-3(d). Enter the excess distribution online 15e, Part V. If the excessdistribution is greater than zero, also complete line 16, Part V.

HDeemed Dividend Election With Respect to a Former PFIC. I, a shareholder of a former PFIC, within the meaning of Regulations section 1.1298-3(a),elect to make a deemed dividend election with respect to the former PFIC. My holding period In the stock of the former PFIC includes the termination date, asdefined in Regulations section 1.1298-3(d). Enter the excess distribution online 15e, Part V. If the excess distribution is greater than zero, alsocomplete line 16, Part V.

01-29-13 LI-IA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 8621 (Rev. 12-2012)

I SU

Form 8621 (Rev. 12-2012) Page 2

Part Ill Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines 6a through 7c. If you are makingElection B, also complete lines 8a through 9c. (See instructions.)

61 Enter your pro rata share of the ordinary earnings of the QEF I 6a Ib Enter the portion of line 6a that Is included in income under section 951 or that may be

excluded under section 1293(g) I 6b IC Subtract line 6b from line 6a. Enter this amount on your tax return as ordinary income ...................................................

7 a Enter your pro rata share of the total net capital gain of the QEF I 7a Ib Enter the portion of line 7a that is included in Income under section 951 or that may be

excluded under section 1293(g) I lbc Subtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule


8 Add lines 6c and 7c ..........................................................................................................................................



c Enter the portion of line 8a not already included in line 8c that Is attributable to shares

in the QEF that you disposed of, pledged, or otherwise transferred during the tax year 8cd Add lines 8b and Bc

e Subtract line 8d from line 8a, and enter the difference (if zero or less, enter amount in brackets)

Important: If line Be is greater than zero, and no portion of line 6a or 7a is includible in income under section 951,you may make Election B with respect to the amount on line Be.

9 a Enter the total tax for the tax year (See Instructions.) .9a


on line 8e

c Subtract line 9b from line 9a. This Is the deferred tax, the time for payment of which is extended by making

Election B

Part IV Gain or (Loss) From Mark-ti ctionsiDa Enter the fair market value of your PFIC stock at the end of the tax year


c Subtract line lOb from line iDa. If a gain, do not complete lines 11 and 12. Include this amount as ordinary income


11 Enter any unreversed inclusions (as defined in section 1296(d)) .ii.

12 Enter the loss from line lOc, but only to the extent of unreversed Inclusions on line 11. Include this amount as an ordinary

losson your tax return ........................................................................................................................................_______________________

13 II you sold or otherwise disposed of any section 1296 stock (see instructions) during the tax year


b Enter the adjusted basis of the stock on the date of sale or disposition

c Subtract line 13b from line 13a. If a gain, do not complete line 14. include this amount as ordinary income on your


14a Enter any unreversed Inclusions (as defined in section 1296(d))


loss on your tax return. If the loss on line 13c exceeds unreversed Inclusions on line 14a, complete line 14c .14b



Form 8621 (Rev. 12-2012)

6c

70

8d

21261201-29-13

SX

V Distributions From and Dispositions of Stock of a Section 1291 Fund (SeeComplete Part Vfor each excess distribution (see instructions).




included in income under section 1291(a)(1)(B)) made by the fund with respect to the applicable stock for each of the 3 years

preceding the current tax year (or 9 shorter, the portion of the shareholders holding period before the current tax year)



e Subtract line 15d from line 15a. This amount, If more than zero, is the excess distribution with respect to the applicable stock.



distribution on your Income tax return











e Subtract line 16d from line 16c. Enter this amount on your income tax return as additional tax.' (See instructions.)


Enter the aggregate amount of Interest here. (See instructions.).................................................................................... 161

Part VI Status of Prior Year Section 1294 Elections and Termination of Section 1294

1,858.

i.. 1,156.12. 578.

723.

1,135.

151

16b1 1.1



election



distributed during the tax yew


return


this return

25 Deterred tax outstanding after



Form 8621 (Rev. 12-2012)

21261301-29-13

EeA

EAr8621 1 Information Return by a Shareholder of a Passive Foi

(Rar.Dbor2012) Investment Company or Qualified Electing FundDepartment of the T IreasuryInternal Revenue Service 111o. Information about Form 8621 and Its separate Instructions is at wwrt, irc nr,r,/frrrmPROl

0M13 No. 1545-1002


Name of shareholder


C/O GELLER & CO, 909 THIRD AVE. NO. 16 FLCity or town, state, and ZIP code or country

NEW YORK, NY 10022Check tvoe of shareholder fume the return:


GILLESPIE CLO P.L.C.


20-5602483Shareholder tax year calendar year U I A or other tax year beginning

and ending

L_i S Corporation L......J Non grantor Trust L..J EstattEmployer identification number (if any)


5 HARBOURMASTER PLACE, INT'L FIN SVC CTRDUBLIN 1, IRELAND



tax year beginningor other

and

Provide the following Information with respect to all shares of the PFIC held by the shareholder

1 Description of each class of shares held by the shareholder[J Check it shares jointly owned with spouse.



4 Value of shares held at the end of the taxable year (check the appropriate box, It applicable):

(a) El $0-50,000 (b) EI $50,001-100,000 (C) El $100,001-150,000

(e) If more than $200,000, list value:(d) E::1$150,001-200,000


1293, or Inclusion or deduction under section 1296:(a)El Section 1291 $________________________(b)El Section 1293 (Qualified Electing Fund) $_________________________

(C) El Section 1296 (Mark to Market) $__________________________

Part II Elections (See instructions.)A Li Election To Treat the PFIC as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF. Complete lines 6a through 7c of Part Ill.B El Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits

of the QEF until this election is terminated. Complete lines 8a through 9c of Part lii to calculate the tax that maybe deferred.Note: If any portion of fine 6a or line 7a of Part li/is includible under section 951, you maynot make this election. Also, see sections1294(c) and 1294(f) and the related regulations for events that terminate this election.


D El Deemed Sale Election. I, a shareholder on the first day of a PFIC's first tax year as a QEF, elect to recognize gain on the deemed sale of my Interest in thePFIC. Enter gain or/oss on line 15f of Part V.

E El Deemed Dividend Election. I, a shareholder on the first day of a PFICs first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat anamount equal to my share of the post-1986 earnings and profits of the CFC as an excess distribution. Enter this amount on fine 15e of Part V. If theexcess distribution is greater than zero, also complete fine 16 of Part V.

F El Election To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, elect to treat as an excessdistribution the gain recognized on the deemed sale of my interest in the PFIC on the last day of Its last tax year as a PFIC under section 1297(a). Entergain online 15f of Part V.

G El Deemed Dividend Election With Respect to a Section 1297(e) PFIC. I, a shareholder of a section 1297(e) PFIC, within the meaning of Regulations section1.1297-3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFIC. My holding period in the stock of the Section 1297(e)PFIC includes the CFC qualification date, as defined in Regulations section 1.1297-3(d). Enter the excess distribution on fine 15e, Part V. If the excessdistribution is greater than zero, also complete fine 16, Part V.

H El Deemed Dividend Election With Respect to a Former PFIC. I, a shareholder of a former PFIC, within the meaning of Regulations section 1.1298-3(a),elect to make a deemed dividend election with respect to the former PFIC. My holding period in the stock of the former PFIC includes the termination date, asdefined in Regulations section 1.1298-3(d). Enter the excess distribution on fine 15e, Part V. If the excess distribution is greater than zero, alsocomplete line 16, Part V.

01-29-13 LHA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 8621 (Rev. 12-2012)

S S

Form 8621 (Rev. 12-2012) Page 2Part Ill Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines 6a through 7c. If you are making

Election B, also complete lines 8a through 9c. (See instructions.) -

6 a Enter your pro rata share of the ordinary earnings of the QEF I 6a Ib Enter the portion of line 6a that Is included in Income under section 951 or that maybe


7 a Enter your pro rata share of the total net capital gain of the QEF .7a Ib Enter the portion of line 7a that is included in income under section 951 or that may be

excluded under section 1293(g) I lb Ic Subtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule


8 a Add lines 6c and 7c ..........................................................................................................................................



Enter the portion of line 8a not already included in line 8c that is attributable to shares

in the QEF that you disposed of, pledged, or otherwise transferred during the tax year 8cd Add lines 8b and 8c ..


Important: If line Be is greater than zero, and no portion of line 6a or 7a Is Includible in income under section 951,you may make Election B with respect to the amount on line Be.



on line 8e 9b


Election B

orlOa Enter the fair market value of your PFIC stock at the end of the tax year

b Enter your adjusted basis in the stock at the end of the tax year .lObc Subtract line lOb from line lOa. If a gain, do not complete lines 11 and 12. Include this amount as ordinary income

on your tax return. If a loss, go to line 11 ..122

11 Enter any unreversed inclusions (as defined in section 1296(d)) .


losson your tax return .......................................................................................................................................__________________________

13 If you sold or otherwise disposed of any section 1296 stock (see instructions) during the tax year

a Enter the fair market value of the stock on the date of sale or disposition .13ab Enter the adjusted basis of the stock on the date of sale or disposition .13bc Subtract line 13b from line 13a. If a gain, do not complete line 14. Include this amount as ordinary income on your

tax return. If a loss, go to line 14 .



loss on your tax return. If the loss on line 13c exceeds unreversed inclusions on line 14a, complete line 14c .


return according to the rules generally applicable for losses provided elsewhere in the Code and regulations .14oNote. See Instructions in case of multiple dispositions.

Form 8621 (Rev. 12-2012)

7c

8d

9c

21261201-29-13

38621irt V a Section 1291 Fund(See

Part Vfor each excess distribution


holding period of the stock began in the current tax year, see Instructions




c Divide line 15b by 3. (See instructions if the number of preceding tax years Is less than 3.)



If zero or less and you did not dispose of stock during the tax year, do notcomplete the rest of Part V. See instructions if you



Enter gain or toss from the disposition of stock of a section 1291 fund or farmer section 1291 fund. If a gain,







return as other income SEE STATEMENT 25o Enter the aggregate increases in tax (before credits) for each tax year in your holding period


d Foreign tax credit (See instructions.)

e Subtract line 16d from line 16c. Enter this amount on your income tax return as"additional tax." (See Instructions.)


15b

2,732.

16b1 2,73

aggregate--------------------,n LIIWI 1110 dIIIUUIIL UI IIIW1OSL terre. (;66 instructions.) I 16f I

Part VI Status of Prior Year Section 1294 Elections and Termination of Section 1294 ElectionsComplete a separate column for each outstanding election. Complete lines 25 and 26 only if there is partial termination of the section1294 election.


election






return


this return





Form 8621 (Rev. 12-2012)

21261301-29-13

I 01^

19Form 8621(Rev. December 20 12)Depastment of the Treasu,yInternal Revenue Service

Name of shareholder

Information Return by a Shareholder of a Passive ForeignInvestment Company or Qualified Electing Fund

is at L MALir gr,v1fnrmRF21


OMB No. 1545-1002


THE BLOOMBERG FAMILY FOUNDATION INC 120-5602483Number, street, and room or suite no. (If a P.O. box, see instructions.) Shareholder tax y.ac calendar year2 012 or other lax year beginning

C/0 GELLER & CO, 909 THIRD AVE, NO. 16 FL I and ening

City or town, state, and ZIP code or country

NEW YORK, NY 10022Check

the

Name of passive foreign Investment company (PFIC) or qualified electing fund (QEF)

HARBOURMASTER CLO 10 LTD.


PBNASSUSTRN, LOCATELLIKADE 11076 AZ AMSTERDAM, NETHERLANDS 1076 AZ



Tax year of PFIC or QEF: calendar year 2012 or other

tax year beginning , and

Part I is reserved for future use

Provide the following information with respect to all shares of the PFIC held by the shareholder

1 Description of each class of shares held by the shareholder.

LJ Check it shares jointly owned with spouse.


3 Number of shares held at the end of the taxable year


(a) i::i $050,000 (b) $50,001-100,000 (C) $100,001-150,000

(d) $150,001-200,000




(a) Section 1291 $________________________

(b)Section 1293 (Qualified Electing Fund) $_________________________

(c) Section 1296 (Mark to Market) $__________________________

Part If Elections (See instructions.)

A L....J Election To Treat the PFIC as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF. Complete fines 6a through 7c of Part Ill.

B EEl Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profitsof the QEF until this election is terminated. Complete fines 8a through 9c of Part /// to calculate the tax that maybe deferred.Note: If any portion of fine 6a or fine 7a of Part Ill is includible under section 951, you maynot make this election. Also, see sections1294(c) and 1294(t) and the related regulations for events that terminate this election.

C EJ Election To Mark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect to mark-to-market the PFIC stock that is marketable within the meaning of section1296(e). Complete Part IV.

D Deemed Sale Election. I, a shareholder on the first day of a PFICs first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in the

PFIC. Enter gain or loss on fine 15f of Part V.

E EE Deemed Dividend Election. I, a shareholder on the first day of a PFIC's first tax year as a QEF that is controlled foreign corporation (CFC), elect to treat anamount equal to my share of the post-1986 earnings and profits of the CFC as an excess distribution. Enter this amount on fine lSe of Part V. If theexcess distribution is greater than zero, also complete fine 16 of Part V.

F EE Election To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC ore PFIC to which section 1297(d) applies, elect to treat as an excessdistribution the gain recognized on the deemed sale of my interest in the PFIC on the last day of its last tax year as a PFIC under section 1297(a). Entergain online 15f of Part V.

GDeemed Dividend Election With Respect to a Section 1297(0) PFIC. I, a shareholder of a section 1297(e) PFIC, within the meaning of Regulations section1.1297-3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFIC. My holding period in the stock of the Section 1297(e)PFIC includes the CFC qualification date, as defined in Regulations section 1.1297-3(d). Enter the excess distribution online 15e, Part V. If the excessdistribution is greater than zero, also complete line 16, Part V.

HDeemed Dividend Election With Respect to a Former PFIC. I, a shareholder of a former PFIC, within the meaning of Regulations section 1.1298-3(a),elect to make a deemed dividend election with respect to the former PFIC. My holding period In the stock of the former PFIC includes the termination date, asdefined in Regulations section 1.1298-3(d). Enter the excess distribution online 15e, Part V. If the excess distribution is greater than zero, alsocomplete line 16, Part V.

01-29-13 u40, For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate Instructions. Form 8621 (Rev. 12-2012)

Ex

19,Form 8621 (Rev. 12-2012)

Page 2Part Ill Income From a Qualified Electing Fund (QEF). All QEF shareholders complete tines 6a through 7c. If you are making

Election B, also complete lines Ba through 9c. (See instructions.)

6 a Enter your pro rata share of the ordinary earnings of the QEF .6a I -Enter the portion of line 6a that is included in income under section 951 or that may be

excluded under section 1293(g) .6b ISubtract line 6b from line 6a. Enter this amount on your tax return as ordinary income ....................................................6c

7 a Enter your pro rata share of the total net capital gain of the QEF I la

b Enter the portion of line 7a that is included In Income under section 951 or that may be

excluded under section 1293(g) I lbC Subtract line 7b from line 7a. This amount is a net tong-term capital gain. Enter this amount in Part II of the Schedule D

used for your income tax return. (See instructions.) .•,

8 Add lines 6c and 7c ...........................................................................................................................................Ba



c Enter the portion of line 8a not already included in line Bc that is attributable to shares

in the QEF that you disposed of, pledged, or otherwise transferred during the tax year 80

d Add lines 8b and Bc 8de Subtract line 8d from line 8a, and enter the difference (if zero or less, enter amount in brackets)

Important: if line Be is greater than zero, and no portion of line Ga or 7a is includible in income under section 951,you may make Election B with respect to the amount online Be.

9 a Enter the total tax for the tax year (See Instructions.) .

b Enter the total tax for the tax year determined without regard to the amount entered Ion line 8e .9b

Subtract line 9b from tine 9a. This is the deferred tax, the time for payment of which Is extended by making

Election B

9cI IV Gain or (Loss) From Mark-to-Market Election (See instructions.)

lOa Enter the fair market value of your PFIC stock at the end of the tax year

b Enter your adjusted basis in the stock at the end of the tax year .lObc Subtract line lOb from line ba. If a gain, do not complete lines 11 and 12. Include this amount as ordinary income







b Enter the adjusted basis of the stock on the date of sate or disposition

c Subtract line 13b from line 13a. If a gain, do not complete line 14. Include this amount as ordinary income on your


14a Enter any unreversed Inclusions (as defined In section 1295(d)) 14ab Enter the loss from line 13c, but only to the extent of unreversed inclusions on line 14a. Include this amount as an ordinary


o Enter the amount by which the loss on line 13c exceeds unreversed inclusions on line 14a. Include this amount on your tax


Form 8621 (Rev. 12-2012)

21261201-29-13

Form 8621 (Rev. 12-2012)Page 3

Part V Distributions From and Dispositions of Stock of a Section 1291 Fund(See instructions.)Complete a Pan' V for each excess distribution (see instructions).








Subtract line 15d from line 15a. This amount, if more than zero, Is the excess distribution with respect to the applicable stock.








that are allocated to days In each tax year.

It Enter the total of the amounts determined in line 16a that are allocable to the current tax year and tax years


return as other income SEE STATEMENT 26Enter the aggregate increases In tax (before credits) for each tax year in your holding period



e Subtract line 16d from line 16c. Enter this amount on your income tax return as "additional tax." (See instructions.)


Enter the aggregate amount of interest here. (See instructions.) ....................................................................................

15a1 1,154.

338.150 169.

211.

943.

.i!. 3,070.

4,013.

16c

16d

16e

161fl_...S. Ill fls_s__ _ a! - a .. -- —

Li.- . - - -

rd.R VI oiaius OT rrior rear ection i14 Elections and Termination of Section 1294 ElectionsComplete a separate column for each outstanding election. Complete lines 25 and 26 only if there is partial termination of the section1294 election.


election







return


this return




terminstinn nf pler'.tinn

Form 8621 (Rev. 12-2012)

21261301-29-13

14Form 8621 I Information Return by a Shareholder of a Passive Foreigni OMBNO.1545.12

"'a Oacomb"20121 Investment Company or Qualified Electing Fund

lntcaal Renenue I Information about Form 8621 and its separate Instructions Is at ; nv/fnR1 Sequence No. 69Department of the Treasury Attachment

Name of shareholder




NEW YORK, NY 10022Check tvDe of shareholder filino the return: L.....i Individual

20-5602483Shareholder tax year calendar arh U .t. h or other tax year beginning

and ending

Trust

Estate

Name of passive foreign Investment company (PFIC) or qualified electing fund (QEF)

MAC FUNDING II, LTD.C/O MAPLES FINANCE LIMITEDAddress (Enter number, street, city or town, and country.)

P.O. BOX 1093GT, QUEENSGATE HOUSE, S. CHURCHGEORGE TOWN, GRAND CAYMAN, CAYMAN ISLANDS




tax year beginning

or other

and


I Description of each class of shares held by the shareholder.

El Check if shares jointly owned with spouse.



4 Value of shares held at the end of the taxable year (check the appropriate box, If applicable):

(a) i::i $0-50,000 (b) [] $50,001-100,000 (c) El $100,001-150,000


(d) El $150,001-200,000



(a)El Section 1291 $________________________(b)El Section 1293 (Qualified Electing Fund) $_________________________

(C) El Section 1296 (Mark to Market) $_____________________

Part II Elections (See instructions.)A L..J Election To Treat the PFIC as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF. Complete lines 6a through 7c of Part III.B El Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits

of the QEF until this election is terminated. Complete lines 8a through 9c of Part III to calculate the tax that may be deferred.Note: If any portion of line 6a or line 7a of Part /I/is includible under section 951, you maynot make this election. Also, see sections1294(c) and 1294(f) and the related regulations for events that terminate this election.

C El Election To Mark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect to mark-to-market the PFIC stock that Is marketable within the meaning of section1296(e). Complete Part IV.

D El Deemed Sale Election. l,a shareholder on the first day of a PFIC's first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in the

PFIC. Enter gain or loss on line 15f of Part V.

E El Deemed Dividend Election. l,a shareholder on the first day of a PFICs firsttax year as a QEF that is a controlled foreign corporation (CFC), elect to treat an

amount equal to my share of the post-1986 earnings and profits of the CFC as an excess distribution. Enter this amount on line 15e of Part V. If theexcess distribution is greater than zero, also complete line 16 of Part V.

F El Election To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, elect to treat as an excessdistribution the gain recognized on the deemed sale of my interest in the PFIC on the last day of its last tax year as a PFIC under section 1297(a). Entergain online 15f of Part V.

G El Deemed Dividend Election With Respect to a Section 1297(e) PFIC. I, a shareholder of a section 1297(e) PFIC, within the meaning of Regulations section1.1297-3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFIC. My holding period In the stock of the Section 1297(e)PFIC includes the CFC qualification date, as defined In Regulations section 1.1297-3(d). Enter the excess distribution on line 15e, Part V. If the excessdistribution is greater than zero, also complete line 16, Part V.

H El Deemed Dividend Election With Respect to a Former PFIC. I, a shareholder of a former PFIC, within the meaning of Regulations section 1.1298.3(a),elect to make a deemed dividend election with respect to the former PFIC. My holding period in the stock of the former PFIC includes the termination date, asdefined in Regulations section 1.1298-3(d). Enter the excess distribution online 15e, Part V. If the excess distribution is greater than zero, alsocomplete line 16, Part V.

IJ-1.A For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 8621 (Rev. 12-2012)

Form 8621 (Rev. 12-2012) Page 2

Part III Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines Ba through 7c. If you are makingElection B, also complete lines 8a through 9c. (See instructions.) -

6 a Enter your pro rata share of the ordinary earnings of the QEF F 6a Ib Enter the portion of line 6a that Is included in income under section 951 or that may be

excluded under section 1293(g) I 6b Ic Subtract line 6b from line 6a. Enter this amount on your tax return as ordinary income ...................................................

7 a Enter your pro rata share of the total net capital gain of the QEF I 7a Ib Enter the portion of line 7a that is included In income under section 951 or that may be

excluded under section 1293(g) .7b IC Subtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule 0



or deemed distributed to you during the tax year of the QEF. (See instructions.) .8bC Enter the portion of line Ba not already included in line 8c that is attributable to shares

in the QEF that you disposed of, pledged, or otherwise transferred during the tax year 8cd Add lines 8b and 8c


Important If line Be is greater than zero, and no portion of line 6a or 7a is Includible in income under section 951,you may make Election B with respect to the amount on fine Be.

9 a Enter the total tax for the tax year (See instructions.) .9a


on line 8e .9b ISubtract line 9b from line 9a. This is the deferred tax, the time for payment of which is extended by making

Election B

t IV Gain or (Loss) From Mark-to-Market Election (See instructions.)10a Enter the fair market value of your PFIC stock at the end of the tax year

b Enter your adjusted basis in the stock at the end of the tax year ................................................... 10bc Subtract line lOb from line ba. If a gain, do not complete lines 11 and 12. Include this amount as ordinary income



12 Enter the loss from line iDe, but only to the extent of unreversed inclusions on line 11. Include this amount as an ordinarylosson your tax return .......................................................................................................................................12


a Enter the fair market value of the stock on the date of sale or disposition .13ab Enter the adjusted basis of the stock on the date of sale or disposition .13bc Subtract line 13b from line 13a. If a gain, do not complete line 14. include this amount as ordinary income on your

tax return, if a loss, go to line 14

14a Enter any unreversed inclusions (as defined in section 1296(d)) .14ab Enter the lass from line 13c, but only to the extent of unreversed inclusions on line 14a. Include this amount as an ordinary

loss on your tax return. if the loss on line 13c exceeds unreversed inclusions on line 14a, complete line 14c .14bc Enter the amount by which the loss online 13c exceeds unreversed Inclusions on line 14a. Include this amount on your tax


Form 8621 (Rev. 12-2012)

6c

70

8d

21261201-29-13

^4

IsForm 8621 (Rev. 12-2012) Page-3

Part V Distributions From and Dispositions of Stock of a Section 1291 Fund(See instructions.)Complete a spparatp Part Vfor each excess distribution (see instructions).




included in income under section 1291(a)(1)(B)) made by the fund with respect to the applicable stock for each of The 3 years


Divide line 15b by 3. (See instructions if the number of preceding tax years Is less than 3.)












before the foreign corporation became a PFIC (pre-PFlc tax years). Enter these amounts on your income tax

return as other income SEE STATEMENT 27c Enter the aggregate increases in tax (before credits) for each tax year in your holding period




I Determine interest on each net increase In tax determined on line 16e using the rates and methods of section 6621.

15a 8.591.

15b1 4,463.

5,801.

151

16b( 5,801.

Enter the aggregate amount of interest here. (See instructions.).................................................................................... I 16f IPart VI Status of Prior Year Section 1294 Elections and Termination of Section 1294 Elections

Complete a separate column for each outstanding election. Complete fines 25 and 26 only if there Is partial termination of the section1294 election.


election



19 Deferred tax


tax (line 19) as of the filing date



distributed daring the lax year


return


this return




Form 8621 (Rev. 12-2012)

21261301-29-13

SA ^iI

Form R121 1 Information Return by a Shareholder of a Passive Fot(Rev. December 2012) Investment Company or Qualified Electing Fund

Information about Fe

is at www ir.r gnv1frJrmR21

Name of shareholder


OMB No, 1545-1002


THE BLOOMBERG FAMILY FOUNDATION INCNumber, street, and room or suite no. (if a P.O. box, see instructions.)

C /O GELLER & CO. 909 THIRD AVE, NO. 16 FL


NEW YORK, NY 10022


MAC CAPITAL, LTD.C/O MAPLES FINANCE LIMITEDAddress (Enter number, street, city or town, and country.)

P.O. BOX 109 3GT, QUEENSGATE HOUSE, S. CHURCHGEORGE TOWN, GRAND CAYMAN, CAYMAN ISLANDS

20-5602483Shareholder tax year calendar year4 U 4 or other tax year beginning

and ending

Li S Corporation L_J Nongrantor Trust Li Estati

Employer Identification number (if any)


Tax year of PFIC or QEF: calendar year A U 12 or other


Of

Part I is reserved for future use


1 Description of each class of shares held by the shareholder.

[2 Check U shares jointly owned with spouse.




(a) [2 $0-50,000 (b) [2 $50,001-100,000 (c) [I$10O,001-150,DOO


(d) [2$150,001-200,000



(a)[2 Section 1291 $________________________

(b)[2 Section 1293 (Qualified Electing Fund) $_________________________

(c)EJ Section 1296 (Mark to Market) $


A L..J Election To Treat the PFIC as a QEF. 1,0 shareholder of a PF1C, elect to treat the PFIC as a QEF. Complete lines 6a through 7c of Part lii.B [2 Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits

of the QEF until this election is terminated. Completefines 8a through 9c of Part Ill to calculate the tax that may be deferred.Note: If any portion of line 6a or line 7a of Part Ill is includible under section 951, you maynot make this election. Also, see sections1294(c) and 1294(t) and the related regulations for events that terminate this election.

C [2 Election To Mark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect to mark-to-marketthe PFIC stock that is marketable within the meaning of section1296(e). Complete Part IV.

D £2 Deemed Sale Election. I, a shareholder on the first day of a PFIC's first tax year as a OEF, elect to recognize gain on the deemed sale of my interest in the

PFIC. Enter gain or loss online 15f of Part V.

E EJ Deemed Dividend Election. I, a shareholder on the first day of a PFIC's first tax year as a QEF that is controlled foreign corporation (CFC), elect to treat anamount equal to my share of the post-1986 earnings and profits of the GFC as an excess distribution. Enter this amount on line 15e of Part V. If theexcess distribution is greater than zero, also complete line 16 of Part V.

F £2 Election To Recognize Gain on Deemed Sale of PFIC. 1,0 shareholder of a former PF1C or a PF1C to which section 1297(d) applies, elect to treat as an excessdistribution the gain recognized on the deemed sale of my Interest in the PFIC on the last day of its last tax year as a PFIC under section 1297(a). Entergain online 15f of Part V.

G [2 Deemed Dividend Election With Respect to a Section 1297(e) PFIC. I, a shareholder of a section 1297(e) PFIC, within the meaning of Regulations section1.1297-3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFIC. My holding period in the stock of the Section 1297(e)PFIC includes the CFC qualification date, as defined in Regulations section 1.1297-3(d). Enter the excess distribution on line 15e, Part V. If the excessdistribution is greater than zero, also complete fine 16, Part V.

[2 Deemed Dividend Election With Respect to a Former PFIC. l,a shareholder of a former PFIC, within the meaning of Regulations section 1.1298-3(a),'' elect to make a deemed dividend election with respect to the former PFIC. My holding period in the stock of the former PFIC includes the termination date, as

defined in Regulations section 1.1298-3(d). Enter the excess distribution online 15e, Part V. If the excess distribution is greater than zero, alsocomplete fine 16, Part V.

-29-13 U-lA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 8621 (Rev. 12-2012)

C CForm 8621 (Rev. 12-2012)


Election B, also complete lines 8a through 9c. (See instructions.)

6 a Enter your pro rata share of the ordinary earnings of the QEF I - 6a Ib Enter the portion of line 6a that is included in income under section 951 or that may be

excluded under section 1293(g) I 6b ISubtract line 6b from line 6a. Enter this amount on your tax return as ordinary Income ...................................................

7 a Enter your pro rata share of the total net capital gain of the QEF I 7a IEnter the portion of line 7a that Is Included In income under section 951 or that may be

excluded under section 1293(g) .7b Ic Subtract line 7b from line 7a. This amount is net long-term capital gain. Enter this amount in Part II of the ScheduleD


8 a Add lines 6c and 7c ..........................................................................................................................................


or deemed distributed to you during the tax year of the QEF. (See instructions.)

c Enter the portion of line Be not already Included in line Be that is attributable to shares

in the QEF that you disposed of, pledged, or otherwise transferred during the tax year 80d Add lines Sb and Sc ..

e Subtract line 8d from line Be, and enter the difference (if zero or less, enter amount in brackets)

Important If line Be is greater than zero, and no portion of line Ba or 7a is includible in income under section 951,you may make Election B with respect to the amount online Be.

9 a Enter the total tax for the tax year (See instructions.) .


on line 8e


Election B

or (Loss) From Mark-to-Market Election (See instructionslOa Enter the fair market value of your PFIC stock at the end of the tax year

b Enter your adjusted basis in the stock at the end of the tax year ..i9

c Subtract line lOb from line lOa. If a gain, do not complete lines 11 and 12. Include this amount as ordinary Income


11 Enter any unreversed inclusions (as defined In section 1296(d)) ..1!









loss on your tax return. If the loss on line 13c exceeds unreversed inclusions on line 14a, complete line 14c .14bc Enter the amount by which the loss on line 13c exceeds unreversed inclusions on line 14a. Include this amount on your tax


Form 8621 (Rev. 12-2012)

7c

8d

9c

21261201-29-13

Form 8621 (Rev. 12-2012) Page 3

Part V Distributions From and Dispositions of Stock of a Section 1291 Fund(See instructions.)Complete a Part Vfor each excess distribution (see instructions).













complete line 16. If a loss, show It in brackets and do not complete line 16 SEEM1T2816 a Attach a statement for each distribution and disposition. Show your holding period for each share of stock





return as other income SEE STATEMENT 29c Enter the aggregate increases In tax (before credits) for each tax year in your holding period

(other than the current tax year and pre'PFIC years). (See instructions.)


Subtract line 16d from line 16c. Enter this amount on your Income tax return as 'additional tax.' (See instructions.)


15a1 87.0

15b1 44,092

15e1 52,388.

52.3

Enter the aggregate amount of Interest here. (See instructions.) ....................... ............................................................. I 16f

Part VI Status of Prior Year Section 1294 Elections and Termination of Section 1294 ElectionsComplete a separate column for each outstanding election. Complete lines 25 and 26 only if there isa partial termination of the section1294 election.


election



19 Deferred tax




return


this return




Form 8621 (Rev. 12-2012)

21261301-29-13

8621 Information Return by a Shareholder of a Passive FoiInvestment Company or Qualified Electing Fund

Information about Form 8621 and its seoarate instructions Is at ,............Department of the TreasuryInternal Revenue Service

Name of shareholder Identifying number (see instructions)

20-5602483

Shareholder tax yeac calendar year2 0 1 4

and ending


C/O GELLER & CO, 909 THIRD AVE. NO. 16 FL

Sri

JI l0No. 1545-1002

ntnce No. 69

or other tax year beginning


NEW YORK, NY 10022

Check type of shareholder filing the return: L...J Individual


MOSELLE CLO S.A.


.ALLE SCHEFFER 12520 LUXEMBOURG, LUXEMBOURG

rart u summary Ot Annual Information Part I is reserved for IProvide the following information with respect to all shares of the PFIC held by the shareholder

I Description of each class of shares held by the shareholder:





(a) fl 80-50,000 (b) E $50,001-100,000 (c) 8100,001-150,000





or othertax year beginning

and

(d) $150,001-200,000

5 Type of PFIC and amount of any excess distribution or gain treated as an excess distribution under Section 1291, inclusion under section


(a)EJ Section 1291 $_________________________

(b) Section 1293 (Qualified Electing Fund) $_________________________

(c) Section 1296 (Mark to Market) $__________________________

Part H Elections (See instructions.)A L..J Election To Treat the PRO as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF. Complete lines 6a through 7c of Part III.B Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits

of the QEF until this election is terminated. Complete fines Ba through 9c of Part Ill to calculate the tax that may be deferred.Note: If any portion of fine 6a of-fine 7a of Part Ill is includible under section 951, you maynot make this election. Also, see sections1294(c) and 1294(t) and the related regulations for events that terminate this election.

C Election To Mark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect to mark-to-market the PFIC stock that is marketable within the meaning of section1296(e). Complete Part IV.

0 EJ Deemed Sale Election. I, a Shareholder on the first day of a PFICs first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in thePFIC. Enter gain or loss online 15f of Part V.

E Deemed Dividend Election. I, a shareholder on the first day of a PFIC's first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat anamount equal to my share of the post-1986 earnings and profits of the CFC as an excess distribution. Enter this amount on line 15e of Part V. If theexcess distribution is greater than zero, also complete line 16 of Part V.

F ED Election To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, elect to treat as an excessdistribution the gain recognized on the deemed sale of my interest in the PFIC on the last day of its last tax year as a PFIC under section 1297(a). Entergain on fine 15f of Part V.

Deemed Dividend Election With Respect to a Section 1297(e) PFIC. I, a shareholder of a section 1297(e) PFIC, within the meaning of Regulations sectionG1.1297-3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFIC. My holding period in the stock of the Section 1297(e)PFIC includes the CFC qualification date, as defined in Regulations section 1.1297-3(d). Enter the excess distribution on fine 15e, Part V. If the excessdistribution is greater than zero, also complete line 16, Part V.

H Deemed Dividend Election With Respect to a Former PFIC. I, a shareholder of a former PFIC, within the meaning of Regulations section 1.1298-3(a),elect to make a deemed dividend election with respect to the former PFIC. My holding period in the stock of the former PFIC includes the termination date, asdefined In Regulations section 1.1298-3(d). Enter the excess distribution on line 15e, Part V. If the excess distribution is greater than zero, alsocomplete line 16, Part V.


S SV 4)

Form 8621 (Rev. 122012)Page 2

Part Ill Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines 6a through lc. If you are makingElection 8, also complete lines 8a through 9c. (See instructions.)

6 a Enter your pro rata share of the ordinary earnings of the QEF I 6a I -b Enter the portion of line 6a that is included in income under section 951 or that may be

excluded under section 1293(g) I 6b Ic Subtract line 6b from line 6a. Enter this amount on your tax return as ordinary income ...................................................

7 a Enter your pro rata share of the total net capital gain of the QEF I 7a Ib Enter the portion of line 7a that Is included in Income under section 951 or that may be

excluded under section 1293(g) I lb Ic Subtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule


8 a Add lines 6c and 7c ..........................................................................................................................................



c Enter the portion of line Be not already included In line 8c that Is attributable to shares


e Subtract line 8d from line Be, and enter the difference (If zero or less, enter amount in brackets)

Important If line 8e is greater than zero, and no portion of line Ga or 7a is includible in income under section 951,you may make Section B with respect to the amount on line Be.

9 a Enter the total tax for the tax year (See instructions.) I ..2._b Enter the total tax for the tax year determined without regard to the amount entered

on line Be L.!!I_C Subtract line 9b from line 9a. This is the deferred tax, the time for payment of which Is extended by making

Election B

Part IV Gain or (Loss) From Mark-to-Market Election (See instruction

IN Enter the fair market value of your PFIC stock at the end of the tax year


C Subtract line lOb from line lOa. If a gain, do not complete lines 11 and 12. Include this amount as ordinary Income



12 Enter the loss from line 10c, but only to the extent of unreversed inclusions on line 11. Include this amount as an ordinary


13 If you sold or otherwise disposed of any section 1296 stock (see Instructions) during the tax year


b Enter the adjusted basis of the stock on the date of sale or disposition .13bc Subtract line 13b from line 13a. If a gain, do not complete line 14. Include this amount as ordinary Income on your


14a Enter any unreversed Inclusions (as defined in section 1296(d)) .14ab Enter the loss from line 13c, but only to the extent of unreversed Inclusions on line 14a. Include this amount as an ordinary

loss on your tax return. If the loss on line 13c exceeds unreversed inclusions on line 14a, complete line 14c .14bc Enter the amount by which the loss online 13c exceeds unreversed inclusions on line 14a. Include this amount on your tax

return according to the rules generally applicable for losses provided elsewhere in the Code and regulations ............... 14cNote. See instructions in case of multiple dispositions.

Form 8621 (Rev. 12-2012)

70

8d

9c

21261201-29-13

&W,

PA

Form 8621 (Rev. 12-2012) Page 3Part V Distributions From and Dispositions of Stock of a Section 1291 Fund (See instructions.)

Complete a Renmte Part V for each excess distribution (see instructions).

NXiri




Included in income under section 1291(a)(1)(B)) made by the fund with respect to the applicable stock for each of the 3 years



III Multiply line 15c by 125% (1.25)












return as other income SEE STATEMENT 30

a Enter the aggregate increases in tax (before credits) for each tax year in your holding period

(other than the current tax year and pre-PFIC years). (See instructions.) .......................................................................

If Foreign tax credit. (See instructions.)


Determine interest on each net increase In tax determined online 16e using the rates and methods of section 6621.

Enter the aggregate amount of interest here. i

50,684.

i_. 19,347.i. 9,674.T5—d

Me 38,591.

233,733.

16b 272,324.



election



19 Deferred tax


tax (line 19) as of the filing date





return


this return





Form 8621 (Rev. 12-2012)

21261301.29.13

Form 86211 Information Return by a Shareholder of a Passive Fot(Rev.December 2012) I Investment Company or Qualified Electing FundDepartment of the Treasury IIntarnal Revenue Service I Information about Form 8621 and its separate instructions Is at www inq nnv1fnrmqR9-t--

Name of shareholder


C/O GELLER & CO, 909 THIRD AVE, NO. 16 FLCity or town, state, and ZIP code or country

NEW YORK, NY 10022


20-5602483 _Shareholder tax year calendar

and

EJ' I0MB No. 1545-1002

[Attachment5equence No. 69



AACP DEBT INVESTORS, L.P.C/0 ASIA ALTERNATIVES MANAGEMENTAddress (Enter number, street, city or town, and country.)

ONE MARITIME PLAZA, SUITE 1000SAN FRANCISCO, CA 94111

Part I Summary of Annual Information Part I is reserved for IProvide the following information with respect to all shares of the PFIC held by the shareholder


EJ Check if shares jointly owned with spouse.




(a) i:J $0-50,000 (b) EJ $50,001-100,000 (c) EJ $100,001-150,000


20-8920779



tax year beginning

endina

(d) El $150,001-200,000

or other

and



1293, or Inclusion or deduction under section 1296:

(a)El Section 1291 $__________________________(b)El Section 1293 (Qualified Electing Fund) $___________________

(C) El Section 1296 (Mark to Market) $________________________

Part II Elections (See instructions)A L..J Election To Treat the PFIC as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF. Complete lines 6a through 7c of Part Ill.

B El Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profitsof the QEF until this election is terminated. Complete lines Ba through 9c of Part Il/to calculate the tax that maybe deferred.Note: If any portion of line 6a or line 7a of Part Il/is includible undersection 951, you maynot make this election. Also, see sections1294(c) and 1294(1) and the related regulations for events that terminate this election.

C El Election To Mark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect to mark-to-market the PFIC stock that is marketable within the meaning of section


D El Deemed Sale Election. l.a shareholder on the first day of a PFICs first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in thePF1C. Enter gain or loss on fine 15f of Part V.

E El Deemed Dividend Election. I, a shareholder on the first day of a PFIC's first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat anamount equal to my share of the post-1986 earnings and profits of the CFC as an excess distribution. Enter this amount on line 15e of Part V. If theexcess distribution is greater than zero, also complete line 16 of Part V.

F El Election To Recognize Gain on Deemed Sale of PFID. I, a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, elect to treat as an excessdistribution the gain recognized on the deemed sale of my interest in the PFIC on the last day of its last tax year as a PFIC under section 1297(a). Entergain on fine 15f of Part V.

G El Deemed Dividend Election With Respect to a Section 1297(e) PFIC. I, a shareholder of a section 1297(e) PFIC, within the meaning of Regulations section1.1297-3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFIC. My holding period in the stock of the Section 1297(e)PFIC includes the CFC qualification date, as defined in Regulations section 1.1297-3(d). Enter the excess distribution on fine 15e, Part V. If the excessdistribution is greater than zero, also complete fine 16, Part V.

H El Deemed Dividend Election With Respect to a Former PFIC. I, a shareholder of a former PFIC, within the meaning of Regulations section 1.1298-3(a),elect to make a deemed dividend election with respect to the former PFIC. My holding period in the stock of The former PFIC includes The termination date, asdefined in Regulations section 1.1298-3(d). Enter the excess distribution on fine 15e, Part V. If the excess distribution is greater than zero, alsocomplete line 16, Part V.

01-2913 li-tA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 8821 (Rev. 12-2012)

Form 6621 (Rev. 12-2012)Pace 2

Part Ill Income From a Qualified Electing Fund (QEF). All OF shareholders complete lines 6a through 7c. If you are makingElection B, also complete lines 8a through 9c. (See instructions.)

6 a Enter your pro rats share of the ordinary earnings of the QEF La I -b Enter the portion of line 6a that is included in income under section 951 or that may be

excluded under section 1293(g) I 6b Io Subtract line 6b from line 6a. Enter this amount on your tax return as ordinary Income ...................................................

7 a Enter your pro rats share of the total net capital gain of the QEF I 7a Ib Enter the portion of line 7a that is included In income under section 951 or that may be

excluded under section 1293(g) I lb

o Subtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule D


8 a Add lines 6c: and ..........................................................................................................................................b Enter the total amount of cash and the fair market value of other property distributed


o Enter the portion of line 8a not already Included in line 8c; that is attributable to shares


e Subtract line 8d from line 8a, and enter the difference (If zero or less, enter amount in brackets)

Important: If line Be is greater than zero, and no portion of line Ga or 7a is includible in income under section 951,you may make Election B with respect to the amount on line Be.



online Be I 9b ISubtract line 9b from line 9a. This Is the deferred tax, the time for payment of which is extended by making

Election B 90Gain or on

10a Enter the fair market value of your PFIC stock at the end of the tax year lOaIi Enter your adjusted basis in the stock at the end of the tax year ...................................................-10C Subtract line lOb from line iDa. If a gain, do not complete lines 11 and 12. Include this amount as ordinary income

on your tax return. If a loss, go to line 11 .100Ii Enter any unreversed inclusions (as defined in section 1296(d)) .



13 It you sold or otherwise disposed of any section 1296 stock (see instructions) during the tax year:


b Enter the adjusted basis of the stock on the date of sale or disposition .13bC Subtract line 13b from line 13a. If a gain, do not complete line 14. Include this amount as ordinary income on your

tax return. If a loss, go to line 14..i

14a Enter any unreversed inclusions (as defined in section 1296(d)) .14a



C Enter the amount by which the loss on line 13c exceeds unreversed inclusions on line 14a. Include this amount on your tax


Form 8621 (Rev. 12-2012)

6c

70

8d

21261201-29-13

Form 8621 (Rev. 12-2012) Page 3Part V Distributions From and Dispositions of Stock of a Section 1291 Fund(See instructions.)

Complete a Part V for each excess distribution (see instructions).15 a Enter your total distributions from the section 1291 fund during the current tax year with respect to the applicable stock. If the



included in income under section 1291(a)(1)(13)) made by the fund with respect to the applicable stock for each of the 3 years



It Multiply line 15c by 125% (1.25)


If zero or less and you did not dispose of stock during the tax year, do notcomplete the rest of Part V. See instructions if you




complete line 16. If a loss, show ft in brackets and do not complete line 16




b Enter the total of the amounts determined In line 16a that are allocable to the current tax year and tax years

before the foreign corporation became a PFIC (pre .PFIC tax years). Enter these amounts on your income tax

return as other income SEE STATEMENT 31o Enter the aggregate Increases In tax (before credits) for each tax year in your holding period



e Subtract line 16d from line 16c. Enter this amount on your income tax return as additional tax." (See instructions.)


Enter the aggregate amount of interest here. (See instructions.

15a

15b

15e

15f1 225,511.

16b1 225,511.

16c

IRE



election






return


this return





Form 8621 (Rev. 12-2012)

21261301-29.13

EfFom 8621 1 Information Return by a Shareholder of a Passive Foi(Rev.Decembe2012) Investment Company or Qualified Electing FundDepartment of the Treasury ,. ,.. ------

OMB No. 1545-1002


Name of shareholder



NEW YORK, NY 10022Check type of shareholder filing the return: L_i Individual LXJ Corporation L..Name of passive foreign investment company (PFIC) or qualified electing fund (QEF)

AACP TAX—EXEMPT INVESTORS FUND III, L.PC/O ASIA ALTERNATIVES MANAGEMENTAddress (Enter number, street, city or town, and country.)



20-5602483Shareholder tax year. cajendan ye& U .1. h or Other tax year beginning

and ending

L.....J S Corporation L....J Nongrantor Trust 0 Estate



Tax year of PFIC or QEF: calendar year 4 U .1. Z or other


Part I Summary of Annual Information Part I is reserved for future use (see instructions).Provide the following information with respect to all shares of the PFIC held by the shareholder.

1 Description of each class of shares held by the shareholderEl Check if shares jointly owned with spouse.




(a) El 80-50,000 (b) i:i 850,001-100,000 (c) El $100,001-150,000 (d) El 8150,001-200,000




(a) EJ Section 1291 $________________________

(b) EIJ Section 1293 (Qualified Electing Fund) $_________________________

(c)El Section 1296 (Mark to Market) $

Part II Elections (See instructions.)A L..J Election To Treat the PFIC as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF. Complete lines 6a through 7c of Part Ill.B El Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits

of the QEF until this election is terminated. Complete lines Ba through 9c of Part Ill to calculate the tax that may be deferred.Note: If any portion of line 6a or line 7a of Part Ill is includible under section 951, you maynof make this election. Also, see sections1294(c) and 1294(1) and the related regulations for events that terminate this election.


D El Deemed Sale Election. I, a shareholder on the first day of a PFICs first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in thePFIC. Enter gain or loss on line 15f of Part V.

E El Deemed Dividend Election. I, a shareholder on the first day of a PFICs first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat anamount equal to my share of the post-1986 earnings and profits of the CFC as an excess distribution. Enter this amount online 15e of Part V. If theexcess distribution is greater than zero, also complete line 16 of Part V.


G El Deemed Dividend Election With Respect to a Section 1297(e) PFIC. I, a shareholder of a section 1297(e) PFIC, within the meaning of Regulations section1.1297-3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFIC. My holding period In the stock of the Section 1297(e)PFIC includes the CFC qualification date, as defined In Regulations section 1.1297-3(d). Enter the excess distribution on line 15e, Part V. If the excessdistribution is greater than zero, also complete line 16, Part V.

H El Deemed Dividend Election With Respect to a Former PFIC. I, a shareholder of a former PFIC, within the meaning of Regulations section 1.1298-3(a),elect to make a deemed dividend election with respect to the former PFIC. My holding period in the stock of the former PFIC includes the termination date, asdefined in Regulations section 1.1298-3(d). Enter the excess distribution online 15e, Part V. If the excess distribution is greater than zero, alsocomplete line 16, Part V.

11 -z2b91-11 3 LHA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate Instructions. Form 8621 (Rev. 12-2012)

V VForm 8621 (Rev. 12-2012) Page 2

Part Ill Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines 6a through it. If you are making

Election B, also complete lines Ba through 9. (See instructions.) -

6 a Enter your pro rata share of the ordinary earnings of the QEF I 6a Ib Enter the portion of line 6a that Is included in income under section 951 or that may be

excluded under section 1293(g) I 6b

Subtract line 6b from line 6a. Enter this amount on your tax return as ordinary income ...................................................

7 a Enter your pro rats share of the total net capital gain of the QEF I 7a Ib Enter the portion of line 7a that is included in income under section 951 or that may be

excluded under section 1293(g) I 7b

o Subtract line 7b from line 7a. This amount Is a net long-term capital gain. Enter this amount in Part II of the Schedule D


8 a Add lines 6c and 7c ..........................................................................................................................................



o Enter the portion of line 8a not already included in line Sc that is attributable to shares



e Subtract line Sd from line 8a, and enter the difference (if zero or less, enter amount in brackets)

Important: if line 8e is greater than zero, and no portion of line Ga or 7a is includible in income under section 951,you may make Election B with respect to the amount on line 8e.



on line 8e I 9b

Subtract line 9b from line 9a. This Is the deferred tax, the time for payment of which Is extended by making

Election B .................................................................................................................................or



c Subtract line lOb from line 10a. If a gain, do not complete lines 11 and 12. Include this amount as ordinary income








tax return. If a loss, go to line 14 .13c

14a Enter any unreversed inclusions (as defined in section 1296(d)) .14a

b Enter the loss from line 13c, but only to the extent of unreversed inclusions online 14a. Include this amount as an ordinary


c Enter the amount by which the loss on line 13c exceeds unreversed inclusions on line 14a. include this amount on your tax

return according to the rules generally applicable for losses provided elsewhere in the Code and regulations .

Note. See instructions in case of multiple dispositions.

Form 8621 (Rev. 12-2012)

60

8d

90

21281201-29.13

Form 8621 (Rev. 12-2012) Page 3

Part V Distributions From and Dispositions of Stock of a Section 1291 Fund (See instructions.)Complete a _qpnaratq Part Vfor each excess distribution (see instructions).


holding period of the stock began in the current tax year, see instructions .iSa -


Included in income under section 1291(a)(1)(13)) made by the fund with respect to the applicable stock for each of the 3 years

preceding the current tax year (or if shorter, the portion of the shareholders holding period before the current tax year) .15b

.

-

Divide line 15b by 3. (See Instructions if the number of preceding tax years is less than 3.) -

d Multiply line 15c by 125% (1.25) ..j -Subtract line 15d from line 15a. This amount if more than zero, is the excess distribution with respect to the applicable stock.



distribution on your income tax return .-







before the foreign corporation became a PFIC (pre-PF1C tax years). Enter these amounts on your income tax

return as other Income SEE STATEMENT 32 16b -

c Enter the aggregate increases in tax (before credits) for each tax year in your holding period


d Foreign tax credit. (See instructions.) .J.!! -e Subtract line 16d from line 16c. Enter this amount on your income tax return as 'additional tax.' (See instructions.) .j. -


Enter the aggregate amount of interest here. (See Instructions.) .................................................................................... .16f -

Part VI Status of Prior Year Section 1294 Elections and Termination of Section 1294 Elections

3,431.

3.4



election





return


this return




Form 8621 (Rev. 12-2012)

21261301-29-13

n.

I [1Form 86211 Information Return by a Shareholder of a Passive Foreign(Rev. December 2012) I Investment Company or Qualified Electing FundDepartment of the TreasuryInternal Revenue se,vlce Oo. Information about Form 8621 and its separate Instructions is at y hName of shareholder Identifying number (see instructions)

OMB No. 1545-1002


THE BLOOMBERG FAMILY FOUNDATION INC 120-5602483Number, street, and room or suite no. (If a P.O. box, see Instructions.)


NEW YORK, NY 10022

Shareholder tax year. Of other tax Year beginning

and

Check type of shareholder filing the return: L......J Individual LJ Corporation LName of passive foreign investment company (PFIC) or qualified electing fund (DEE)

AACP TAX—EXEMPT INVESTORS FUND II, L.P.C/O ASIA ALTERNATIVES MANAGEMENTAddress (Enter number, street, city or town, and country.)



98-0615699Reference ID number (see instructions)

Tax year of PFIC or QEF: calendar year or othertax year beginning and

useProvide the following information with respect to all shares of the PFIC held by the shareholder






(a) $0-50,000 (b) El $50,001-100,000 (c) r: $100,001-150,000

(e) If more than $200,000, list value:(d) El $150,001-200,000



(a) Section 1291 $________________________

(b)E7 Section 1293 (Qualified Electing Fund) $________________________

(c) ED Section 1296 (Mark to Market) $________________________


A L.J Election To Treat the PFIC as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF. Complete lines 6a through 7c of Part Ill.B UJ Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits

of the DEE until this election is terminated. Complete lines 8a through 9c of Part Il/to calculate the tax that maybe deferred.Note: If any portion of line 6a or line 7a of Part Ill Is Includible undersection 951, you may 0 make this election. Also, see sections1294(c) and 1294(l) and the related regulations for events that terminate this election.

C i::i Election To Mark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect to mark-to-market the PFIC stock that is marketable within the meaning of section1296(e). Complete Part IV.

0 LJ Deemed Sale Election. I, a shareholder on the first day of a PFICs first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in thePFIC. Enter gain or loss online 15f of Part V.

E U Deemed Dividend Election. I, a shareholder on the first day of a PFIC's first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat anamount equal to my share of the post-1986 earnings and profits of the CFC as an excess distribution. Enter this amount on line 15e of Part V. If theexcess distribution is greater than zero, also complete line 16 of Part V.

F E11 Election To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, elect to treat as an excessdistribution the gain recognized on the deemed sale of my interest in the PFIC on the last day of its last tax year as a PFIC under section 1297(a). Entergain online 15f of Part V.

Deemed Dividend Election With Respect to a Section 1297(e) PFIC. I, a shareholder of a section 1297(e) PFIC, within the meaning of Regulations sectionG1.1297-3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFIC. My holding period in the stock of the Section 1297(e)PFIC includes the CFC qualification date, as defined in Regulations section 1.1297-3(d). Enter the excess distribution on line 15e, Part V. If the excessdistribution is greater than zero, also complete line 16, Part V.

H Deemed Dividend Election With Respect to a Former PFIC. I, a shareholder of a former PFIC, within the meaning of Regulations section 1.1298.3(a),elect to make a deemed dividend election with respect to the former PFIC. My holding period in the stock of the former PFIC includes the termination date, asdefined in Regulations section 1.1298-3(d). Enter the excess distribution on line 15e, Part V. If the excess distribution is greater than zero, alsocomplete line 16, Part V.

01-29-13 LI-iA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 8621 (Rev. 12-2012)

UJ

^i*Form 8621 (Rev. 12-2012)

Page 2Part Ill Income From a Qualified Electing Fund (QE9. All QEF shareholders complete lines Ba through 7c. If you are making

Election B, also complete lines Ba through Bc. (See instructions.) -

6 a Enter your pro rata share of the ordinary earnings of the QEF I 6a Ib Enter the portion of line Be that is included in income under section 951 or that may be

excluded under section 1293(g) I 6b Io Subtract line 6b from line 6a. Enter this amount on your tax return as ordinary Income ...................................................

7 a Enter your pro rata share of the total net capital gain of the CEF I ia Ib Enter the portion of line 7a that is included in income under section 951 or that may be

excluded under section 1293(g) .m IC Subtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount In Part II of the Schedule D


8 a Add lines 6c and 7c ..........................................................................................................................................



o Enter the portion of line Ba not already included in line Bc that is attributable to shares




Important: if line 8e is greater than zero, and no portion of line 6a or 7a Is includible in income under section 951,you may make Section B with respect to the amount on line Be.



on line 8e .9b

c Subtract line 9b from line Ba. This Is the deferred tax, the time for payment of which is extended by making

or



o Subtract line lOb from line lOa. If a gain, do not complete lines 11 and 12. Include this amount as ordinary income



12 Enter the loss from line 10c, but only to the extent of unreversed inclusions on line 11. Include this amount as an ordinary


13 It you sold or otherwise disposed of any section 1296 stock (see Instructions) during the tax year











Form 8621 (Rev. 12-2012)

6c

7c

8d

I 9c

12

13a

21261201-29-13

Form 8621 (Rev. 12-2012)Page

Part V Distributions From and Dispositions of Stock of a Section 1291 Fund (See instructions,)Complete asopnrate Part Vfor each excess distribution (see instructions).




included In income under section 1291(a)(1)(13)) made by the fund with respect to the applicable stock for each of the 3 years


Divide line 15b by 3. (See instructions if the number of preceding tax years Is less than 3.)












before the foreign corporation became a PFIC (pre .PFIC tax years). Enter these amounts on your income tax

return as other income SEE STATEMENT 33c Enter the aggregate increases in tax (before credits) for each tax year in your holding period



e Subtract line 16d from line 16c. Enter this amount on your income tax return as 'additional tax? (See instructions.)


Enter the aggregate amount of interest here. (See instructions.) ....................................................................................

15b

15e

15f1 8,852.

16b1 8,852.

1160

16fPart VI Status of Prior Year Section 1294 Elections and Termination of Section 1294 Elections

Complete a separate column for each outstanding election. Complete lines 25 and 26 only if there Is a partial termination of the section1294 election.


election








return


this return





Form 8621 (Rev. 12-2012)

21261301-29-13

NAFoev 86211 Information Return by a Shareholder of a Passive Forei(Rev.December2Ol2) Investment Company or Qualified Electing FundDepattment of the TreasuryInternal Revenue Service Information about Form 8621 and its se

Name of shareholder

ns is at


OMB No. 1545102


THE BLOOMBERG FAMILY FOUNDATION INCNumber, street, and room or suite no. (If a P.O. ho; see instructions.)

C/O GELLER & CO. 909 THIRD AVE, NO. 16 FLCity or town, state, and ZIP code or country

NEW YORK, NY 10022of shareholder filino the


ALTOR FUND III (NO. 2) LP

20-5602483Shareholder tax year. Calendar year U I Z or other tax year beginning

and ending

L.....J S Corporation L....J Nongrantor Trust L...J —Estatf



P.O. BOX 730, 11-15 SEATON PLACEST. HELIER, JERSEY JE JE4 OQH


1 Description of each class of shares held by the shareholder.El Check if shares jointly owned with spouse.



98-0594714Reference ID number (see instructions)

Tax year of PFIC or aEF: calendar year or otherlax year beginning and

re use


(a) El $0-50,000 (b) El $50,001-100,000 (C) El $100,001-150,000 (d) El $150,001-200,000(e) If more than $200,000, list value:



(a) EJ Section 1291 $_________________________(b)El Section 1293 (Qualified Electing Fund) $_________________________

(C) E11 Section 1296 (Mark to Market) $_________________________

Part II Elections (See instructions.)A L.....J Election To Treat the PFIC as a QEF. l.a shareholder of a PFIC, elect to treat the PFIC as a QEF. Complete lines Ga through 7c of Part Ill.B El Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits

of the QEF until this election is terminated. Complete lines Ba through 9c of Part Ill to calculate the tax that maybe deferred.Note: If any portion of line 6a or line 7a of Part Ill is includible under section 951, you maynot make this election. Also, see sections1294(c) and 1294(1) and the related regulations for events that terminate this election.


D El Deemed Sale Election. I, a shareholder on the first day of a PFICs first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in thePFIC. Enter gain or loss online 15! of Part V.

E El Deemed Dividend Election. I, a shareholder on the first day of a PFICs first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat anamount equal to my share of the post-1986 earnings and profits of the CFC as an excess distribution. Enter this amount on line 15e of Part V. If theexcess distribution is greater than zero, also complete line 16 of Part V.

F El Election To Recognize Gain on Deemed Sale of PFIC. l.a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, elect to treat as an excessdistribution the gain recognized on the deemed sale of my interest In the PFIC on the last day of its last tax year as a PFIC under section 1297(a). Entergain online 15f of Part V.

G El Deemed Dividend Election With Respect to a Section 1297(e) PFIC. I, a shareholder eta section 1297(e) PFIC, within the meaning of Regulations section1.1297-3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFIC. My holding period in the stock of the Section 1297(e)PFIC includes the CFC qualification date, as defined in Regulations section 1.1297-3(d). Enter the excess distribution online 15e, Part V. If the excessdistribution is greater than zero, also complete line 16, Part V.

H El Deemed Dividend Election With Respect to a Former PFIC. I, a shareholder of a former PFIC, within the meaning of Regulations section 1.1298-3(a),elect to make a deemed dividend election with respect to the former PFIC. My holding period in the stock of the former PFIC includes the termination date, asdefined In Regulations section 1.1298-3(d). Enter the excess distribution on line 15e, Part V. If the excess distribution is greater than zero, alsocomplete line 16, Part V.


ElForm 8621 (Rev. 12-2012)



6 a Enter your pro rata share of the ordinary earnings of the QEF I 6a Ib Enter the portion of line Ga that is included in Income under section 951 or that may be

excluded under section 1293(g) Leb Ic Subtract line 6b from line 6a. Enter this amount on your tax return as ordinary Income ...................................................

7 a Enter your pro rata share of the total net capital gain of the QEF I 7ab Enter the portion of line 7a that is included In income under section 951 or that may be

excluded under section 1293(g) I 7b Ic Subtract line 7b from tine 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the ScheduleD


8 a Add lines Bc and 7c ..........................................................................................................................................


or deemed distributed to you during the tax year of the QEF. (See instructions.) .••._ ______________________

Enter the portion of line 8a not already Included in line 8c that is attributable to shares

in the QEF that you disposed of, pledged, or otherwise transferred during the tax year 8cd Add lines 8b and 8c ....


Important If line 8e is greater than zero, and no portion of fine 6a or 7a is includible in income under section 951,you may make Election B with respect to the amount on line 8e.

9 a Enter the total tax for the tax year (See Instructions.)


on line 8e 9b

c Subtract line 9b from line 9a. This is the deferred tax, the time for payment of which is extended by making

orlOa Enter the fair market value of your PFIC stock at the end of the tax year lOa


c Subtract line lOb from line lOa. If a gain, do not complete lines 11 and 12. Include this amount as ordinary income

on your tax return. If a loss, go to line 11 Joe11 Enter any unreversed inclusions (as defined in section 1296(d))


loss on your tax return .i?..









o Enter the amount by which the loss on line 13c exceeds unreversed inclusions on line 14a. Include this amount on your tax

return according to the rules generally applicable for losses provided elsewhere in the Code and regulations .j. 1Note. See instructions in case of multiple dispositions.

Form 8621 (Rev. 12-2012)

6c

7c

8d

21261201-29-13

Form 8621 (Rev. 12-2012) Page 3

Part V Distributions From and Dispositions of Stock of a Section 1291 Fund (See instructions.)Complete a spnarate Part Vfor each excess distribution (see instructions).




included in Income under section 1291(a)(1)(B)) made by the fund with respect to the applicable stock for each of the 3 years


c Divide line 15b by 3. (See instructions if the number of preceding tax years Is less than 3.)

d Multiply line 15c by 1250/.(1.25)












return as other income SEE STATEMENT 34o Enter the aggregate increases in tax (before credits) for each tax year in your holding period




Determine interest on each net Increase in tax determined on line 16e using the rates and methods of section 6621.

Enter the aggregate amount of interest here. (See instructions.)

rart vi status of Prior Year Section 1294 Elections and Termination of Section 1294 ElectionsComplete a separate column for each outstanding election. Complete lines 25 and 26 only if there is partial termination of the section1294 election.


election







this return




Form 8621 (Rev. 12-2012)

15a

15e

31,020.

31.0

21261301-29-13

2

: iForm 86211 Information Return by a Shareholder of a Passive Fo,(Revecember2012)

InCompany or Qualified Electing Fund

Depalment of the Treasury If.......4.... r..... enni ....l ...

OMB No. 1545-1002


Name of shareholder


C/OGELLER & CO, 909 THIRD AVE. NO. 16 FLCity or town, state, and ZIP code or country

NEW YORK, NY 10022

Check type of shareholder flung the return: L....J Individual LJ Corporation L...J Partnersl


ROCKWALL INVESTORS CORP.C/O MAPLESFS LIMITEDAddress (Enter number, street, city or town, and country.)

P.O. BOX 1093, BOUNDARY HALL, CRICKET SQUAREGRAND CAYMAN, KY1 —1102, CAYMAN ISLANDS


20-5602483Shareholder tax year: calendar year U .1. ,& or other tax year beginning

and ending

L.J S Corporation L...J Nongrantor Trust L...J Estat




or other

tax year beginning

and

Summary of

Part I is reserved for

re use


I Description of each class of shares held by the shareholder.

El Check it shares jointly owned with spouse.




(a) El $0-50,000 (b) EJ $50,001-100,000 (C) c: $100,001-150,000


(d) El $150,001-200,000


1293, or inclusion or deduction under Section 1296:

(a) El Section 1291 $________________________

(b) El Section 1293 (Qualified Electing Fund) $_________________________

(c) El Section 1296 (Mark to Market) $


A L_..] Election To Treat the PFIC as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF. Complete fines Ga through 7c of Part I/I.

B El Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profitsof the QEF until this election is terminated. Complete lines 8a through 9c of Part Ill to calculate the tax that may be deferred.Note: If any portion of fine Ga or line 7a of Part III is includible under section 951, you mayno t make this election. Also, see sections1294(c) and 1294(t) and the related regulations for events that terminate this election.


D Ll Deemed Sale Election. I, a shareholder on the first day of a PFICs first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in thePFIC. Enter gain or loss on fine 15f of Part V.

E El Deemed Dividend Election. I, a shareholder on the first day of a PFICs first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat an

amount equal to my share of the post-1986 earnings and profits of the CFC as an excess distribution. Enter this amount on fine 15e of Part V. If theexcess distribution is greater than zero, also complete fine 16 of Part V.


G El Deemed Dividend Election With Respect to a Section 1297(e) PFIC. I, a shareholder of a section 1297(e) PFIC, within the meaning of Regulations section1.1297-3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFIC. My holding period in the stock of the Section 1297(e)PFIC includes the CFC qualification date, as defined in Regulations section 1.1297-3(d). Enter the excess distribution on fine 15e, Part V. If the excessdistribution is greater than zero, also complete line 16, Part V.

H El Deemed Dividend Election With Respect to a Former PFIC. I, a shareholder of a former PFIC, within the meaning of Regulations section 1.1298-3(a),elect to make a deemed dividend election with respect to the former PFIC. My holding period in the stock of the former PFIC includes the termination date, asdefined in Regulations section 1.1298-3(d). Enter the excess distribution on fine 15e, Part V. If the excess distribution is greater than zero, alsocomplete line 16, Part V.

u-tA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 8621 (Rev. 12-2012)

^01Form 0621 (Rev. 122012)

Page 2Part lii Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines 6a through 7c. It you are making


6 a Enter your pro rata share of the ordinary earnings 01 the OEF

b Enter the portion of line 6a that Is included in income under section 951 or that may be

excluded under section 1293(g) I 6b ISubtract line 6b from line 6a. Enter this amount on your tax return as ordinary income ....................................................6c

7 a Enter your pro rata share of the total net capital gain of the QEF I lab Enter the portion of line 7a that is included in Income under section 951 or that may be

excluded under section 1293(g) I lb ISubtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule D

used for your Income tax return. (See Instructions.)

8 a Add lines 6c and 7c ...........................................................................................................................................8a


or deemed distributed to you during the tax year of the QEF. (See instructions.) ._•_ ______________________

o Enter the portion of line 8a not already included in line Bc that Is attributable to shares

in the QEF that you disposed of, pledged, or otherwise transferred during the tax year Bc

d Add lines 8b and Bc 8de Subtract line 8d from line 8a, and enter the difference (if zero or less, enter amount in brackets)

Important If line Be is greater than zero, and no portion of line 6a or 7a is includible in income under section 951,you may make Election B with respect to the amount online Be.



on line 8e .

o Subtract line 9b from line 9a. This Is the deferred tax, the time for payment of which is extended by making

ElectionB .............................................................................................

orba Enter the fair market value of your PFIC stock at the end of the tax year


Subtract line lOb from line lOa. If a gain, do not complete lines 11 and 12. Include this amount as ordinary Income






a Enter the fair market value of the stock on the date of sale or disposition 13ab Enter the adjusted basis of the stock on the date of sale or disposition

C Subtract line 13b from line 13a. If a gain, do not complete line 14. Include this amount as ordinary Income on your



b Enter the loss from line 13c, but only to the extent of unreversed Inclusions on line 14a. Include this amount as an ordinary

loss on your tax return. If the loss on line 13c exceeds unreversed inclusions on line 14a, complete line 14c ..1.o Enter the amount by which the loss on line 13c exceeds unreversed inclusions on line 14a. Include this amount on your tax


Form 8621 (Rev. 12-2012)

212612O1-2913

O IForm 8621 (Rev. 12-2012)

Page 3

Part V Distributions From and Dispositions of Stock of a Section 1291 Fund(See instructions.)Complete a Part Vfo,r each excess distribution (see instructions).






Divide line 15b by 3. (See instructions it the number of preceding tax years is less than 3.)





distribution on your Income tax return







before the foreign corporation became a PFIC (pre-PFIC tax years). Enter these amounts on your Income tax





I Determine interest on each net increase in tax determined on line 16e using the rates and methods of section 6621.

Enter the aggregate amount of interest here. (See instructions.)....................................................................................

VI Status of Prior Year Section 1294 Elections and Termination of Section 1294 ElectionsComplete a separate column for each outstanding election. Complete lines 25 and 26 only if there is partial termination of the section1294 election.


election







this return




termnstinn nf p.lp.r.tirtn

Form 8621 (Rev. 12-2012)

18,048.

15b

15e1 18,048.

151

16b1 18,048.

16c

21261301-29-13

Name of shareholder


C/O GELIEJER & CO, 909 THIRD AVE. NO. 16 FL


20-5602483Shareholder tax year. calendar year2 014

and endlnq

N'tForm o 8621I Information Return by a Shareholder of a Passive F

Investment Company or Qualified Electing FurDepartment of the Treasury InternalRevenue Service Information about Form 8621 and its separate instructions is at tylywiry v1fr,'nR21


NEW YORK, NY 10022

Check tvoe of shareholder fume the return:

JI I0MB No. 1545.1002




PARTNERS GROUP GLOBAL OPPORTUNITIES LIMITED


P.O. BOX 477, TUDOR HOUSEST. PETER PORT, GUERNSEY



EJ Check if shares jointly owned with spouse.




(a) El $0-50,000 (b) $50,001-100,000 (C) $100,001-150,000






and

use

(d) $150,001-200,000



(a) LIJ Section 1291 $__________________________

(b)U Section 1293 (Qualified Electing Fund) $________________________

(c)U Section 1296 (Mark to Market) $

Part II Elections (See instructions.)A L....J Election To Treat the PFIC as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF. Complete lines 6a through 7c of Part ill.B LJ Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits

of the QEF until this election is terminated. Completelines 8a Through 9c of Part /// to calculate the tax that maybe deferred.Note: If any portion of line Ga or line 7a of Part

ill is includible under section 951, you maynot make this election. Also, see sections

1294(c) and 1294(t) and the related regulations for events that terminate this election.C U Election To Mark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect to mark-to-market the PFIC stock that is marketable within the meaning of section


0 EXi Deemed Sale Election. I, a shareholder on the first day of a PFICs first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in thePFIC. Enter gain or loss on line 15f of Part V.

U Deemed Dividend Election. I, a shareholder on the first day of a PFIC's first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat anamount equal to my share of the post-1986 earnings and profits of the CFC as an excess distribution. Enter this amount on line 15e of Part V. if theexcess distribution is greater than zero, also complete line 16 of Part V.

F U Election To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, elect to treat as an excessdistribution the gain recognized on the deemed sale of my interest in the PFIC on the last day of its last tax year as a PFIC under section 1297(a). Entergain on fine 15f of Part V.

G Deemed Dividend Election With Respect to a Section 1297(e) PFIC. l,a shareholder of a section 1297(e) PFIC, within the meaning of Regulations section1.1297-3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFIC. My holding period In the stock of the Section 1297(e)PFIC includes the CFC qualification date, as defined in Regulations section 1.1297-3(d). Enter the excess distribution on line 15e, Part V. If the excessdistribution is greater than zero, also complete line 16, Part V.

H Deemed Dividend Election With Respect to a Former PFIC. I, a shareholder of a former PFIC, within the meaning of Regulations section 1.1298-3(a),elect to make a deemed dividend election with respect to the former PFIC. My holding period In the stock of the former PFIC includes the termination date, asdefined In Regulations section 1.1298-3(d). Enter the excess distribution on line 15e, Part V. if the excess distribution is greater than zero, alsocomplete line 16, Part V.

LHA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 8621 (Rev. 12-2012)

0 0Form 8621 (Rev. 12-2012)

Page 2Part Ill Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines Ba through 7c. If you are making


6 a Enter your pro rata share of the ordinary earnings of the QEF I 6a Ib Enter the portion of line 6a that is included in income under section 951 or that maybe

excluded under section 1293(g)L6b ISubtract line Sb from line Ba. Enter this amount on your tax return as ordinary income ..........................................

7 a Enter your pro rata share of the total net capital gain of the QEF I ia Ib Enter the portion of line 7a that is included in income under section 951 or that may be

excluded under section 1293(g)j 7b Io Subtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule D


8 a Add lines 6c and 7c ..........................................................................................................................................


or deemed distributed to you during the tax year of the QEF. (See instructions.) .8bC Enter the portion of line Ba not already included in line Sc that is attributable to shares


d Add lines Sb and 8c


Important: If line Be is greater than zero, and no portion of line 6a or 7a is Includible in income under section 951,you may make Election B with respect to the amount online Be.

9a Enter the total tax for the tax year (See instructions.) .

te b Enter the total tax for the tax year determined without regard to the amount enred

on line Be 9bC Subtract line 9b from line 9a. This Is the deferred tax, the time for payment of which is extended by making

Election B 90ain or on


b Enter your adjusted basis in the stock at the end of the tax year .

o Subtract line lOb from line lOa. If a gain, do not complete lines 11 and 12. Include this amount as ordinary income






a Enter the fair market value of the stock on the date of sale or disposition .

b Enter the adjusted basis of the stock on the date of sale or disposition .

o Subtract line 13b from line 13a. If a gain, do not complete line 14. Include this amount as ordinary income on your


14a Enter any unreversed inclusions (as defined in section 1296(d)) ._14a






Form 8621 (Rev. 12-2012)

I 6c

70

21261201-29-13

Form 8621 (Rev. 12-2012) Page 3Part V Distributions From and Dispositions of Stock of a Section 1291 Fund(See instructions.)

Complete a Part V for each excess distribution (see instructions).

15 a Enter your total distributions from the section 1291 fund during the current tax year with respect to the applicable stock. If the—



included In income under section 1291(a)(1)(B)) made by the fund with respect to the applicable stock for each of the 3 years

preceding the current tax year (or if shorter, the portion 01 the shareholders holding period before the current tax year)

o Divide line 15b by 3. (See instructions if the number of preceding tax years is less than 3.)

it Multiply line 15c by 125% (1.25)





Enter gain or loss from the disposition of stock of a section 1291 fund or former section 1291 fund, It a gain,






before the foreign corporation became a PFIC (pre-PFIC tax years). Enter these amounts on your Income tax


Enter the aggregate Increases in tax (before credits) for each tax year in your holding period



e Subtract line 16d from line 16c. Enter this amount on your income tax return as'additional tax.' (See instructions.)

I Determine interest on each net increase in tax determined on line 16e using the rates and methods of section 6621.•1.--------

_____..._& -' Interest "ere. •__._- -------CEnter 1110 oyjitgae OIIIUUIIL UI IiIt -0101 nero. l,ee tflSUUCIIOflS.) I IN I



election






return


this return

25 Defamed tax outstanding altar



Form 8621 (Rev. 12-2012)

15b

10,055.

10,055.

16C

21261301-29.13

S

SA.

Form 8621(Rev. December 2012)Department of the TreasuryInternal Revenue Service

Name of shareholder

Information Return by a Shareholder of a Passive FoiInvestment Company or Qualified Electing Fund

and its separate instructions is


OMB No. 1545.1002


THE BLOOMBERG FAMILY FOUNDATION INC 120-5602483Number, street, and room or suite no. (If a P.O. box, see instructions.)


NEW YORK, NY 10022Check tvoe of shareholder filino the return:


BROOKSIDE CAYMAN LTD.


Shareholder tax year calendar year4 U 1 2 or other tax year beginning

and ending

L..J S Corporation L_J Nongrantor Trust L...J Estati



Part I Summary of Annual Information Part I is reserved for futiProvide the following information with respect to all shares of the PFIC held by the shareholder

1 Description of each class of shares held by the shareholderEl Check if shares jointly owned with spouse.


3 Number of shares held atthe end of the taxable year:


(a) El $0-50,000 (b) El $50,001-100,000 (C) El $100,001-150,000


Tax year of PFIC or QEF: calendar year or othertax year beginning andending

(d) EJ $150,001-200,000



(a) EJ Section 1291 $________________________

(b) EJ Section 1293 (Qualified Electing Fund) $________________________

(c) El Section 1296 (Mark to Market) $_________________________

Part II Elections (See instructions.)A L.....J Election To Treat the PFIC as a QEF. I, a shareholder of a PFIC, elect to treat the PFIC as a QEF. Complete lines 6a through 7c of Part Ill.B El Election To Extend Time For Payment of Tax. I, a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits

of the QEF until this election is terminated. Complete lines 8a through 9c of Part Ill to calculate the tax that may be deferred.Note: If any portion of line 6a or line 7a of Part /// is Includible under section 951, you maynot make this election. Also, see sections1294(c) and 1294(t) and the related regulations for events that terminate this election.

C El Election To Mark-to-Market PFIC Stock. I, a shareholder of a PFIC, elect to mark-to-market the PFIG stock that is marketable within the meaning of section1296(e). Complete Part IV.

D c:i Deemed Sale Election. I, a shareholder on the first day of a PFICs first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in thePFIC. Enter gain or loss online 15f of Part V.

E El Deemed Dividend Election. I, a shareholder on the first day of a PFICs first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat anamount equal to my share of the post-1986 earnings and profits of the CFC as an excess distribution. Enter this amount on line 15e of Part V. If theexcess distribution is greater than zero, also complete line 16 of Part V.

F El Election To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, elect to treat as an excessdistribution the gain recognized on the deemed sale of my interest in the PFIC on the last day of its last tax year as a PFIC under section 1297(a). Entergain on line 15f of Part V.

G El Deemed Dividend Election With Respect to a Section 1297(e) PFIC. I, a shareholder of a section 1297(e) PFIC, within the meaning of Regulations section1.1297-3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFIC. My holding period In the stock of the Section 1297(e)PFIC Includes the CFC qualification date, as defined in Regulations section 1.1297-3(d). Enter the excess distribution on line 15e, Part V. If the excessdistribution is greater than zero, also complete fine 16, Part V.

El Deemed Dividend Election With Respect to a Former PFIC. I, a shareholder of a former PFIC, within the meaning of Regulations section 1.1298-3(a),elect to make a deemed dividend election with respect to the former PFIC. My holding period in the stock of the former PFIC includes the termination date, asdefined In Regulations section 1.1298-3(d). Enter the excess distribution online 15e, Part V. If the excess distribution is greater than zero, alsocomplete fine 16, Part V.

01-29-13 u-i.. For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 8621 (Rev. 12-2012)

Form 8621 (Rev. 12-2012) Page 2Part Ill Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines 6a through 7c. If you are making


6a Enter your pro rata share of the ordinary earnings of the QEF .6a Ib Enter the portion of line 6a that is included in Income under section 951 or that may be

excluded under section 1293(g) I 6b ISubtract line Sb from line 6a. Enter this amount on your tax return as ordinary Income ................................................... 60

7a Enter your pro rata share of the total net capital gain of the QEF J 7a Ib Enter the portion of line 7a that is included in income under section 951 or that maybe

excluded under section 1293(g) I 7b ISubtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule D

used for your income tax return. (See instructions.) ..i

8 a Add lines 6c and 7c ........................................................................................................................................... aab Enter the total amount of cash and the fair market value of other property distributed


c Enter the portion of line Ba not already included in line 8c that is attributable to shares




Important If line Be is greater than zero, and no portion of line 6a or 7a Is includible in income under section 951,you may make Election B with respect to the amount on fine Be.

ga9 a Enter the total tax for the tax year (See instructions.)


on line Be 9b

C Subtract line 9b from line 9a. This is the deferred tax, the time for payment of which is extended by making

9cor



c Subtract line lOb from line lOa. If a gain, do not complete lines 11 and 12. Include this amount as ordinary income



12 Enter the loss from line bc, but only to the extent of unreversed inclusions on line 11. Include this amount as an ordinary

loss on your tax return ....................................................................................................................................... 1213 If you sold or otherwise disposed of any section 1296 stock (see Instructions) during the tax year


13ab Enter the adjusted basis of the stock on the date of sale or disposition



14a Enter any unreversed inclusions (as defined in section 1296(d)) ..j.!



c Enter the amount by which the loss on line 13c exceeds unreversed Inclusions on line 14a. Include this amount on your tax


Form 8621 (Rev. 12-2012)

21261201-29-13

AlForm 8621 (Rev. 12-2012) Plane 3

Part V Distributions From and Dispositions of Stock of a Section 1291 Fund(See instructions.)- Complete a eoamte Part Vfor each excess distribution (see instructions).




included In Income under section 1291(a)(1)(13)) made by the fund with respect to the applicable stock for each of the 3 years



it Multiply line 15c by 1259/6 (1.25)


It zero or less and you did not dispose of stock during the tax year, do not complete the rest of Part V. See instructions if you




complete line 16.11 a loss, show it in brackets and do not complete line 16







(other than the current tax year and pre-PFIC years). (See instructions.) ...........................................................




Enter the aooreaate amount of interest here. (See instructions.

15a

15b

15e

15f 1 10,323.

323.

VI Status of Prior Year Section 1294 Elections and Termination of Section 1294 ElectionsComplete a separate column for each outstanding election. Complete lines 25 and 26 only if there Is partial termination of the section1294 election.


election



19 Deferred tax


tax (line 19) as of the Cling date



distributed during the lax year


return


this return




Form 8621 (Rev. 12-2012)

21261301-29-13

I .El Di

Form 86211 Information Return by a Shareholder of a Passive Foi(Rev, December I Investment Company or Qualified Electing FundDepartment of the Treasury

INo-Intemel Revenue Service 1 - _Information about Form 8621 and its separate instructions is at mnvw i, nnv1fnrmR91

OMB No. 1545-1002


Name of shareholder

THE BLOOMBERG FAMILY FOUNDATION INCN umber, street, and room or suite no. (If a P.O. box, see instructions.)


NEW YORK, NY 10022Check Noe of shareholder filino the return: 77 Individual


TPG—AXON PARTNERS (OFFSHORE), LTD.



20-5602483Shareholder tax year: calendar year U 1A or other tax year beginning

and ending

L..J S Corporation L......J Nongrantor Trust L.J Estat





and



EJ Check U shares jointly owned with spouse.




(a) $0-50,000 (b) $50,001-100,000 (C) $100,001-150,000

(a) It more than $200,000, list value:

(d) $150,001-200,000



(a) Section 1291 $__________________________

(b) Section 1293 (Qualified Electing Fund) $____________________

(c) LII Section 1296 (Mark to Market) $_________________________

Part H Elections (See instructions.)A Li Election To Treat the PFIC as a QEF. l.a shareholder of a PFIC, elect to treat the PFIC as a DEF. Complete lines 6a through 7c of Part Ill.B LJ Election To Extend Time For Payment of Tax. l.a shareholder of a QEF, elect to extend the time for payment of tax on the undistributed earnings and profits

of the QEF until this election is terminated. Complete fines Sa through 9c of Part Ill to calculate the tax that may be deferred.Note: If any portion of fine 6a or line 7a of Part 1/1 is includible under section 951, you maynot make this election. Also, see sections1294(c) and 1294(1) and the related regulations for events that terminate this election.


D EIi Deemed Sale Election. I, a shareholder on the first day of a PFIC's first tax year as a QEF, elect to recognize gain on the deemed sale of my interest in thePFIC. Enter gain orloss on line 15f of Part V.

E Deemed Dividend Election. I, a shareholder on the first day of a PFICs first tax year as a QEF that is a controlled foreign corporation (CFC), elect to treat anamount equal to my share of the post-1986 earnings and profits of the CFC as an excess distribution. Enter this amount on line 15e of Part V. If theexcess distribution is greater than zero, also complete line 16 of Part V.

F Election To Recognize Gain on Deemed Sale of PFIC. I, a shareholder of a former PFIC or a PFIC to which section 1297(d) applies, electto treat as an excessdistribution the gain recognized on the deemed sale of my interest in the PFIC on the last day of its last tax year as a PFIC under section 1297(a). Entergain online 15f of Part V.

G Deemed Dividend Election With Respect to a Section 1297(e) PFIC. I, a shareholder of a section 1297(e) PFIC, within the meaning of Regulations section1.1297-3(a), elect to make a deemed dividend election with respect to the Section 1297(e) PFIC. My holding period in the stock of the Section 1297(e)PFIC Includes the CFC qualification date, as defined in Regulations section 1.1297-3(d). Enter the excess distribution on line 15e, Part V. If the excessdistribution is greater than zero, also complete fine 16, Part V.

H Deemed Dividend Election With Respect to a Former PFIC. I, a shareholder of a former PFIC, within the meaning of Regulations section 1.1298-3(a),elect to make a deemed dividend election with respect to the former PFIC. My holding period in the stock of the former PFIC includes the termination date, asdefined in Regulations section 1.1298-3(d). Enter the excess distribution on fine 15e, Part V. If the excess distribution is greater than zero, alsocomplete line 16, Part V.

01-29-13 U-IA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 8621 (Rev. 12-2012)

Form 8621 (Rev. 12-2012) Page 2Part Ill Income From a Qualified Electing Fund (QEF). All QEF shareholders complete lines 6a through 7c. Ifyou are making

Election B, also complete lines 8a through Sc. (See instructions.)

6 a Enter your pro rata share of the ordinary earnings of the flEE .6a Ib Enter the portion of line 6a that is included in income under section 951 or that may be

excluded under section 1293(g) I 6b Io Subtract line 6b from line 6a. Enter this amount on your tax return as ordinary income ...................................................

7 a Enter your pro rata share of the total net capital gain of the QEF I 7a Ib Enter the portion of line 7a that is Included in income under section 951 or that may be

excluded under section 1293(g) I 7b Ic Subtract line 7b from line 7a. This amount is a net long-term capital gain. Enter this amount in Part II of the Schedule D




o Enter the portion of line 8a not already included In line Sc that is attributable to shares

in the flEE that you disposed of, pledged, or otherwise transferred during the tax year 8e



Important: If line Be is greater than zero, and no portion of line Ba or 7a is Includible in income under section 951,you may make Election B with respect to the amount on line 8e.

9 a Enter the total tax for the tax year (See instructions.) .99


on line 8e I Yb ISubtract line Yb from line 9a. This is the deferred tax, the time for payment of which is extended by making

Election B

rt IV Gain or (Loss) From Mark-to-Market Election (See instructions.iDa Enter the fair market value of your PFIC stock at the end of the tax year

.•!b Enter your adjusted basis in the stock at the end of the tax year

.lot)

incomeo Subtract line lOb from line iDa. If a gain, do not complete lines 11 and 12. Include this amount as ordinary

on your tax return. If a loss, go to line 11 ..i

11 Enter any unreversed Inclusions (as defined in section 1296(d)) ._ii_


losson your tax return ........................................................................................................................................13 If you sold or otherwise disposed of any section 1296 stock (see instructions) during the tax year:

a Enter the fair market value of the stock on the date of sale or disposition .

b Enter the adjusted basis of the stock on the date of sale or disposition .

o Subtract line 13b from line 13a. If a gain, do not complete line 14. Include this amount as ordinary Income on your




loss on your tax return. If the loss on line 13c exceeds unreversed inclusions on line 14a, complete line 14c .j..o Enter the amount by which the loss on line 13c exceeds unreversed inclusions on line 14a. Include this amount on your tax

return according to the rules generally applicable for losses provided elsewhere in the Code and regulations .j. Note. See instructions in case of multiple dispositions.

Form 8621 (Rev. 12-2012)

6c

8d

21261201-29-13

14

^ AForm 8621 (Rev. 12-2012) Page 3

Part V Distributions From and Dispositions of Stock of a Section 1291 Fund(See instructions.)- Complete a Part Vfor each excess distribution (see instructions).




Included in income under section 1291(a)(1)(B)) made by the fund with respect to the applicable stock for each of the 3 years




Subtract line 15d from tine 15a. This amount, if more than zero, is the excess distribution with respect to the applicable stock.






03.286.>16 a Attach a statement for each distribution and disposition. Show your holding period for each share of stock


that are allocated to days In each tax year.




<703.286.>o Enter the aggregate Increases In tax (before credits) for each tax year in your holding period



e Subtract line 16d from line 16c. Enter this amount on your income tax return as additional tax? (See instructions.)


Enter the aggregate amount of interest here. (See instructions.)....................................................................................



election



19 Deterred tax


tax (tine 19) as of the filing date





return


this return





Form 8621 (Rev. 12-2012)

21261301-29.13

ITHE BLOOMBERG FAMILY AUNDATION INC 20-5602483

FORM 8621 DISTRIBUTIONS OF STOCK IN A SECTION 1291 FUND STATEMENT 21

12/16/1012/31/12

PERIOD461.

461.

0.

11/23/1012/31/12

PERIOD3,458.

3,458.

0.

04/22/1012/31/12

PERIOD34,580.

34,580.

0.

12/16/1012/31/12

1. DATE STOCK PURCHASED2. DATE STOCK DISPOSED OF OR DISTRIBUTED3. EXCESS DISTRIBUTION ALLOCATED TO EACH DAY IN HOLDING4. TOTAL ALLOCABLE TO EACH TAX YEAR IN HOLDING PERIOD5. TOTAL ALLOCABLE TO THE CURRENT TAX YEAR AND

PRE-PFIC TAX YEARS, IF DIFFERENT6. TOTAL TO LINE 16B (LINE 4 OR 5)7. TAX. TOTAL TO LINE 16C8. FOREIGN TAX CREDIT. TOTAL TO LINE 16D9. NET TAX. TOTAL TO LINE 16E10. INTEREST. TOTAL TO LINE 16F





1. DATE STOCK PURCHASED2. DATE STOCK DISPOSED OF OR DISTRIBUTED3. EXCESS DISTRIBUTION ALLOCATED TO EACH DAY IN HOLDING PERIOD4. TOTAL ALLOCABLE TO EACH TAX YEAR IN HOLDING PERIOD5. TOTAL ALLOCABLE TO THE CURRENT TAX YEAR AND


922.

922.

['p


THE Bri0OMBERG FAMILY F JNDATION INC

1920-5602483


1. DATE STOCK PURCHASED 09/16/102. DATE STOCK DISPOSED OF OR DISTRIBUTED 12/31/123. EXCESS DISTRIBUTION ALLOCATED TO EACH DAY IN HOLDING PERIOD4. TOTAL ALLOCABLE TO EACH TAX YEAR IN HOLDING PERIOD5. TOTAL ALLOCABLE TO THE CURRENT TAX YEAR AND


1,431.

1,431.

116 STATEMENT(S) 2217171111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOONFA2

THE BLOOMBERG FAMILY F (JNDATION INC 20-5602483


I. DATE STOCK PURCHASED 09/16/102 DATE STOCK DISPOSED OF OR DISTRIBUTED 12/31/123. EXCESS DISTRIBUTION ALLOCATED TO EACH DAY IN HOLDING PERIOD4. TOTAL ALLOCABLE TO EACH TAX YEAR IN HOLDING PERIOD5. TOTAL ALLOCABLE TO THE CURRENT TAX YEAR AND


1,277.

1,277.

['p

117 STATEMENT(S) 2317171111 737725 BLOOMF.ANFND 2012.04040 THE BLOONBERG FAMILY FOTJNDA BLOOMFA2

THE BLOOMBERG FAMILY(JNDATION INC 20-5602483


1.. DATE STOCK PURCHASED 09/16/102. DATE STOCK DISPOSED OF OR DISTRIBUTED 12/31/123. EXCESS DISTRIBUTION ALLOCATED TO EACH DAY IN HOLDING PERIOD4. TOTAL ALLOCABLE TO EACH TAX YEAR IN HOLDING PERIOD

1,135.

5. TOTAL ALLOCABLE TO THE CURRENT TAX YEAR ANDPRE-PFIC TAX YEARS, IF DIFFERENT

6. TOTAL TO LINE 16B (LINE 4 OR 5)

1,135.7. TAX. TOTAL TO LINE 16C8. FOREIGN TAX CREDIT. TOTAL TO LINE 16D9. NET TAX. TOTAL TO LINE 16E10. INTEREST. TOTAL TO LINE 16F

118 STATEMENT(S) 2417171111 737725 BLOOMF.ANFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

THE BLOOMBERG FAMILY 1NDATION INC 20-5602483


DATE STOCK PURCHASED 11/23/10DATE STOCK DISPOSED OF OR DISTRIBUTED 04/25/12EXCESS DISTRIBUTION ALLOCATED TO EACH DAY IN HOLDING PERIODTOTAL ALLOCABLE TO EACH TAX YEAR IN HOLDING PERIODTOTAL ALLOCABLE TO THE CURRENT TAX YEAR ANDPRE-PFIC TAX YEARS, IF DIFFERENT

TOTAL TO LINE 16B (LINE 4 OR 5)TAX. TOTAL TO LINE 16CFOREIGN TAX CREDIT. TOTAL TO LINE 16DNET TAX. TOTAL TO LINE 16EINTEREST. TOTAL TO LINE 16F



1.2.3.4.5.

6.7.8.9.10.

1.2.3.4.5.

6.7.8.9.10.

1,205.

1,205.

0.

1,527.

1,527.

0.


THE BLOOMBERG FAMILY 1NDATION INC 20-5602483


10/15/1011/06/12

PERIOD3,070.

3,070.

0.

10/15/1012/31/12

PERIOD943.

943.

0.






THE BLOOMBERG FAMILY AMDATION INC 20-5602483




1.2.3.4.5.

6.7.8.9.10.

5,801.

5,801.


THE BLOOMBERG FAMILY AMATION INC [I]

20-5602483

FORM 8621 DISTRIBUTIONS/DISPOSITIONS OF SEC 1291 STOCK STATEMENT 28

15A ENTER THE TOTAL DISTRIBUTIONS FROM THE PFIC DURING THECURRENT TAX YEAR. IF THE HOLDING PERIOD OF THE PFIC STOCKBEGAN IN THE CURRENT TAX YEAR, THIS AMOUNT IS DIVIDENDINCOME TO THE EXTENT THERE ARE ACCUMULATED EARNINGS ANDPROFITS

B ENTER THE TOTAL DISTRIBUTIONS (REDUCED BY THE PORTIONS OFSUCH DISTRIBUTIONS THAT WERE EXCESS DISTRIBUTIONS BUT NOTINCLUDED IN INCOME UNDER SECTION 1291(A)(1)(B)) MADE BYTHE COMPANY FOR EACH OF THE 3 YEARS PRECEEDING THECURRENT TAX YEAR (OR IF SHORTER, THE PORTION OF THESHAREHOLDER'S HOLDING PERIOD BEFORE THE CURRENT TAX YEAR)

C DIVIDE LINE 15B BY 3D MULTIPLE LINE 15C BY 125%. ENTER THE LESSER OF LINE 15A

OR LINE 15D AS DIVIDEND INCOME ON YOUR INCOME TAX RETURNE SUBTRACT LINE 15D FROM LINE 15A. THIS AMOUNT, IF MORE THAN

ZERO, IS THE TOTAL EXCESS DISTRIBUTION. IF ZERO OR LESSAND YOU DID NOT DISPOSE OF STOCK DURING THE TAX YEAR, DONOT COMPLETE THE REST OF PART IV

F ENTER GAIN OR LOSS FROM THE DISPOSITION OF STOCK OF ASECTION 1291 FUND OR A FORMER SECTION 1291 FUND. IF AGAIN, COMPLETE LINE 16. IF A LOSS, SHOW IT IN BRACKETSAND DO NOT COMPLETE LINE 16

15A ENTER THE TOTAL DISTRIBUTIONS FROM THE PFIC DURING THECURRENT TAX YEAR. IF THE HOLDING PERIOD OF THE PFIC STOCKBEGAN IN THE CURRENT TAX YEAR, THIS AMOUNT IS DIVIDENDINCOME TO THE EXTENT THERE ARE ACCUMULATED EARNINGS ANDPROFITS

B ENTER THE TOTAL DISTRIBUTIONS (REDUCED BY THE PORTIONS OFSUCH DISTRIBUTIONS THAT WERE EXCESS DISTRIBUTIONS BUT NOTINCLUDED IN INCOME UNDER SECTION 1291(A)(1)(B)) MADE BYTHE COMPANY FOR EACH OF THE 3 YEARS PRECEEDING THECURRENT TAX YEAR (OR IF SHORTER, THE PORTION OF THESHAREHOLDER'S HOLDING PERIOD BEFORE THE CURRENT TAX YEAR)

C DIVIDE LINE 15B BY 3D MULTIPLE LINE 15C BY 125%. ENTER THE LESSER OF LINE 15A

OR LINE 15D AS DIVIDEND INCOME ON YOUR INCOME TAX RETURNE SUBTRACT LINE 15D FROM LINE 15A. THIS AMOUNT, IF MORE THAN

ZERO, IS THE TOTAL EXCESS DISTRIBUTION. IF ZERO OR LESSAND YOU DID NOT DISPOSE OF STOCK DURING THE TAX YEAR, DONOT COMPLETE THE REST OF PART IV

F ENTER GAIN OR LOSS FROM THE DISPOSITION OF STOCK OF ASECTION 1291 FUND OR A FORMER SECTION 1291 FUND. IF AGAIN, COMPLETE LINE 16. IF A LOSS, SHOW IT IN BRACKETSAND DO NOT COMPLETE LINE 16

64,649.

32,751.16,376.

20,470.

44,179.

22,385.

11,341.11,341.

14,176.

8,209.


STHE BLOOMBERG FAMILY NDATION INC

20-5602483


04/15/1012/31/12

PERIOD44,181.

44,181.

0.

02/24/1112/31/12

PERIOD8,207.

8,207.

0.






THE BLOOMBERG FAMILY AUNDATION INC

IF-A

20-5602483


03/26/1009/12/12

PERIOD19,619.

19,619.

0.

03/26/1009/12/12

PERIOD176,572.

176,572.

0.

12/11/1109/12/12

PERIOD37,542.

37,542.

0.

03/26/1012/31/12

PERIOD2,385.

2,385.

0.










DATE STOCK PURCHASEDDATE STOCK DISPOSED OF OR DISTRIBUTEDEXCESS DISTRIBUTION ALLOCATED TO EACH DAY IN HOLDING PERIODTOTAL ALLOCABLE TO EACH TAX YEAR IN HOLDING PERIODTOTAL ALLOCABLE TO THE CURRENT TAX YEAR ANDPRE-PFIC TAX YEARS, IF DIFFERENTTOTAL TO LINE 16B (LINE 4 OR 5)TAX. TOTAL TO LINE 16CFOREIGN TAX CREDIT. TOTAL TO LINE 16DNET TAX. TOTAL TO LINE 16EINTEREST. TOTAL TO LINE 16FDATE STOCK PURCHASEDDATE STOCK DISPOSED OF OR DISTRIBUTEDEXCESS DISTRIBUTION ALLOCATED TO EACH DAY IN HOLDING PERIODTOTAL ALLOCABLE TO EACH TAX YEAR IN HOLDING PERIODTOTAL ALLOCABLE TO THE CURRENT TAX YEAR ANDPRE-PFIC TAX YEARS, IF DIFFERENTTOTAL TO LINE 16B (LINE 4 OR 5)TAX. TOTAL TO LINE 16CFOREIGN TAX CREDIT. TOTAL TO LINE 16DNET TAX. TOTAL TO LINE 16EINTEREST. TOTAL TO LINE 16F

1.2.3.4.5.6.7.8.9.

10.

1.2.3.4.5.6.7.8.9.

10.

114THE BLOOMBERG FAMILY AUNDATION INC 20-560248303/26/1012/31/12

21,462.

21,462.

0.

12/12/1112/31/1214,744.

14,744.

0.


THE BLOOMBERG FAMILY FATION INCND 20-5602483

FORE 8621 DISTRIBUTIONS OF STOCK IN A SECTION 1291 FUND STATEMENT 31

07/01/1007/31/12

80,866.

80,866.

0.

07/01/1010/09/12

144 ,645.

144,645.

0.


PRE'-PFIC TAX YEARS, IF DIFFERENT6. TOTAL TO LINE 16B (LINE 4 OR 5)7. TAX. TOTAL TO LINE 16C8. FOREIGN TAX CREDIT. TOTAL TO LINE 16D9. NET TAX. TOTAL TO LINE 16E10. INTEREST. TOTAL TO LINE 16F




THE BLOOMBERG FAMILY ANDATION INC 20-5602483


DATE STOCK PURCHASEDDATE STOCK DISPOSED OF OR DISTRIBUTEDEXCESS DISTRIBUTION ALLOCATED TO EACH DAY IN HOLDINGTOTAL ALLOCABLE TO EACH TAX YEAR IN HOLDING PERIODTOTAL ALLOCABLE TO THE CURRENT TAX YEAR ANDPRE-PFIC TAX YEARS, IF DIFFERENTTOTAL TO LINE 16B (LINE 4 OR 5)TAX. TOTAL TO LINE 16CFOREIGN TAX CREDIT. TOTAL TO LINE 16DNET TAX. TOTAL TO LINE 16EINTEREST. TOTAL TO LINE 16FDATE STOCK PURCHASEDDATE STOCK DISPOSED OF OR DISTRIBUTEDEXCESS DISTRIBUTION ALLOCATED TO EACH DAY IN HOLDINGTOTAL ALLOCABLE TO EACH TAX YEAR IN HOLDING PERIODTOTAL ALLOCABLE TO THE CURRENT TAX YEAR ANDPRE-PFIC TAX YEARS, IF DIFFERENTTOTAL TO LINE 16B (LINE 4 OR 5)TAX. TOTAL TO LINE 16CFOREIGN TAX CREDIT. TOTAL TO LINE 16DNET TAX. TOTAL TO LINE 16EINTEREST. TOTAL TO LINE 16F

1.2.3.4.5.6.7.8.9.10.1.2.3.4.5.6.7.8.9.10.

02/23/1202/23/12PERIOD49.

49.

0.

02/23/1205/18/12PERIOD2,604.

2,604.

0.

DATE STOCK PURCHASED 02/23/12DATE STOCK DISPOSED OF OR DISTRIBUTED 08/07/12EXCESS DISTRIBUTION ALLOCATED TO EACH DAY IN HOLDING PERIODTOTAL ALLOCABLE TO EACH TAX YEAR IN HOLDING PERIODTOTAL ALLOCABLE TO THE CURRENT TAX YEAR ANDPRE-PFIC TAX YEARS, IF DIFFERENTTOTAL TO LINE 16B (LINE 4 OR 5)TAX. TOTAL TO LINE 16CFOREIGN TAX CREDIT. TOTAL TO LINE 16DNET TAX. TOTAL TO LINE 16EINTEREST. TOTAL TO LINE 16F

1.2.3.4.5.6.7.8.9.10.

778.

778.

0.


THE BLOOMBERG FAMILY FNDATION INC 20-5602483






07/01/1001/17/12

1,171.

1,171.

0.

07/01/1007/24/12

7,681.

7,681.

0.


S

is

THE BLOOMBERG FAMILY &DATION INC

20-5602483


04/01/0903/13/12

<1,938.>

<1,938.>

0.

04/01/0910/23/12

32,958.

32,958.

0.






THE BLOOMBERG FAMILY &DATION INC - 20-5602483


04/08/1001/01/12

18,048.

18,048.

0.




THE BLOOMBERG FAMILY 1tNDATION INC 20-5602483






I. DATE STOCK PURCHASED2. DATE STOCK DISPOSED OF OR DISTRIBUTED3. EXCESS DISTRIBUTION ALLOCATED TO EACH DAY IN HOLDING PERIOD4. TOTAL ALLOCABLE TO EACH TAX YEAR IN HOLDING PERIOD5. TOTAL ALLOCABLE TO THE CURRENT TAX YEAR AND




07/06/1102/08/12

2,825.

2,825.

0.

07/06/1105/10/12

2,611.

2,611.

0.

07/06/1108/03/12

2,369.

2,369.

0.

07/06/1111/01/12

2,250.

2,250.

0.

131 STATEMENT(s) 3617171111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

THE BLOOMBERG FAMILY (JNDATION INC 20-5602483


01/01/0812/31/12

10,323.

10,323.

0.




THE BLOOMBERG FAMILY (JNDATION INC 20-5602483


01/01/0812/31/12

<703,286.>

<703,286.>

0.



133 STATEMENT(S) 3817171111 737725 BLIOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

E#

:z

Form 8886

Reportable Transaction Disclosure Statement(Rev. March 2011)

Aftach to your tax return.Department of the Treasury

See separate instructions.

Name(s) shown on return (individuals enter last name, first name, middle initial)


OMB No. 1545-1800


Identifying number

20-5602483Number, street, and room or suite no. I City or town, state, and ZIP code

C/O GELLER & CO, 909 THIRD AVE. NO. 16 NEW YORK, NY 10022A If you are filing more than one Form 8886 with your tax return, sequentially number each Form 8886 and enter the statement number

for this Form 8888 ...................................................... Statement number 1 of 4B Enter the form number of the tax return to which this form Is attached or related ................................................................. 00. 99 0 —PF

Enter the year of the tax return identified above 2012

Is this Form 8886 being filed with an amended tax return? ................................................................................................ L..J Yes LXJ No

C Check the box(es) that apply (see instructions). L --- J Initial year filer L...J Protective disclosure

I Name of reportable transaction

FOREIGN CURRENCY LOSS PURSUANT TO IRC SECTION 988lb Initial year participated in transaction

ic Reportable transaction or tax shelter registration number

2009

2 identify the type of reportable transaction. Check all boxes that apply (see instructions).

a LJ Listed c Contractual protection e EiJ Transaction of interest

b EJ Confidential d EJ Loss

3 lfyou checked box2a or2e, enterthe published guidance numberforthe listed transactionortransaction of interest

4 Enter the number of 'same as or substantially similar transactions reported on this form ...............................................................

5 If you participated in this reportable transaction through a partnership, S corporation, trust, and foreign entity, check the applicable boxes and provide the

information below for the entity(s) (see instructions). (Attach additional sheets, Ifnecessary.)

a Type of entity Imp- Partnership Trust Partnership Trust

S corporation Foreign L1 S corporation Foreign

b Name

SEE STATEMENT 39c Employer identification number (EIN), if known

d Date Schedule K-i received from entity (enter

'none' if Schedule K-i not received) ............

6

Enter below the name and address of each individual or entity to whom you paid a fee with regard to the transaction if that individual or entity promoted, solicited, or

recommended your participation in the transaction, or provided tax advice related to the transaction. (Attach additional sheets, if necessary.)

a

Name t Identifying number (if known) I Fees paid

Number, street, and room or suite no.

City or town, State, and ZIP code

b Name

Identifying number (if known) I Fees paid



05-01 212 LI-IA For Paperwork Reduction Act Notice, see separate Instructions. Form 8886 (Rev. 3-2011)

13517171111 737725 BLOOMFAMFND 2012.04040 THE BLOONBERG FAMILY FOTJNDA BLOOMFA2

THE BLOOMBERG FAMILY OMATION INCAMA U. 20-5602483

Forni8805 (Rev. 3-2011) Page 2

7 Facts

a Identify the type of tax benefit generated by the transaction. Check all the boxes that apply (see instructions).

El Deductions LJ Exclusions from gross income LJ Absence of adjustments to basis Tax Credits

El Capital loss El Nonrecognition of gain El Deferral

LXI Ordinary loss El Adjustments to basis El Other

b Further describe the amount and nature of the expected tax treatment and expected tax benefits generated by the transaction for all affected years. Include facts of

each step of the transaction that relate to the expected tax benefits including the amount and nature of your investment. Include in your description your

participation in the transaction and all related transactions regardless of the year in which they were entered into. Also, include a description of any tax result

protection with respect to the transaction.

FOREIGN CURRENCY LOSS OF 67,565 THROUGH INVESTMENT IN UNDERLYINGPARTNERSHIP PURSUANT TO IRC SECTION 988.

Identify all individuals and entities involved in the transaction that are tax-exempt, foreign, or related. Check the appropriate box(es) (see instructions). Include their

name(s), identifying number(s), address(es), and a brief description of their involvement For each foreign entity, identify its country of incorporation or existence. For

each individual or related entity, explain how the individual or entity Is related. Attach additional sheets, if necessary.

a Type of individual or entity: E:]Tax-exempt El Foreign EJ Related

Name

Identifying number

Address

Description

b Type of individual or

Related

Name

Identifying number

Address

Description

4ib 405-01-12 Form 8886 (Rev. 3-2011)


A

I 7A8886

(Rev. March 2011)

Depalment of the Treasury

Reportable Transaction Disclosure StatementAttach to your tax return.


OMB No, 1545-1800


Identifying number

20-5602483Name(s) shown on return (individuals enter last name, first name, middle initial)

THE BLOOMBERG FAMILY FOUNDATION INCNumber, street, and room or suite no.

RW or town, state, and ZIP code

C /O GELLER & CO, 909 THIRD AVE. NO. 16 YORK, NY 10022A If are filing more than one Form 8886 with your tax return, sequentially number each Form 8886 and enter the statement number

forthis Form 8886 ........ Statement number 2 of 4B Enter the form number of the tax return to which this form is attached or related 990 PF

Enter the year of the tax return identified above ................................................................ 110. 2012Is this Form 8886 being filed with an amended tax return? ................................................................................................ L..J Yes LXJ No

C Check the box(es) that apply (see instructions). L...J Initial year filer LI Protective disclosure

I a Name of reportable transaction


20112 Identify the type of reportable transaction. Check all boxes that apply (see instructions).

a EJ Listed c Contractual protection e i::ii Transaction of interest

b El Confidential d EXI Loss

3 If you checked box 2a or2e, enter the published guidance number for the listed transactionor transaction of interest ...........

4 Enter the number of 'same as or substantially similar transactions reported on this form 00.

5 If you participated In this reportable transaction through a partnership, S corporation, trust, and foreign entity, check the applicable boxes and provide the

information below for the entity(s) (see instructions). (Attach additional sheets, If necessary.)

a Type of entity ... El Partnership El Trust El Partnership El TrustEl S corporation El Foreign El S corporation El Foreign

b Name



'none' if Schedule K-i not received) 00.

6 Enter below the name and address of each individual or entity to whom you paid a fee with regard to the transaction if that individual or entity promoted, solicited, or

recommended your participation In the transaction, or provided tax advice related to the transaction. (Attach additional sheets, if necessary.)

a Name Identifying number (it known) Fees paid

$



b Name




05-01-12 LI-IA For Paperwork Reduction Act Notice, see separate instructions. Form 8886 (Rev. 3-2011)

13717171111 737725 ELOOMFANFND 2012.04040 THE BLOONBERG FAMILY FOUNDA BLOOMFA2


THE BLOOMBERG FAMILY JNDATION INC 20-5602483

Form 6886 (Rev. 3-2011) Page 2

7 Facts


El Deductions EJ Exclusions from gross income El Absence of adjustments to basis 11111 Tax Credits

EJ Capital loss El Nonrecognition of gain El Deferral

lj Ordinary loss El Adjustments to basis El Other

Further describe the amount and nature of the expected tax treatment and expected tax benefits generated by the transaction for all affected years. Include facts of

each step of the transaction that relate to the expected tax benefits including the amount and nature of your investment Include In your description your





name(s), Identifying number(s), address(es), and a brief description of their Involvement For each foreign entity, identity its country of incorporation or existence. For

each individual or related entity, explain how the individual or entity is related. Attach additional sheets, if necessary.

a Type of individual or entity LJ Tax-exempt El Foreign EJ Related

Name I Identifying number

Address

Description


Related

Name

Identifying number

Address

Description

1u* 1405-01-12 Form 8886Pev.3.2011l


[All8886

(Rev. March 2011)Depaztnt of the Treasury

Reportable Transaction Disclosure Statement)0- Attach to your tax return.


OMB No. 1545.1800



Identifying number

THE BLOOMBERG FAMILY—FOUNDATION INC

20-5602483Number, street, and room or suite no. I City or town, state, and ZIP code

C /O GELLER & CO, 909 THIRD AVE. NO. 16 IIvTEW YORK, NY 10022A Uyou are filing more than one Form 8886 with your tax return, sequentially number each Form 8886 and enter the statement number

for this Form 8886 .......................................... Statement number 3 of 4B Enter the form number of the tax return to which this form is attached or related ON. 990 —PF

Enter the year of the tax return identified above 2012Is this Form 8886 being filed with an amended tax return? ................................................................................................ =Yes LXJ No

C Check the box(es) that apply (see instructions). LX] Initial year filer L.J Protective disclosure

la Name of reportable transaction




a Listed o El Contractual protection e EJ Transaction of interest

EJ Confidential d LJ Loss

3 If you checked box 2a or 2e, enter the published guidance number for the listed transactionor transaction of interest .

4 Enter the number of 'same as or substantially similar transactions reported on this form.................


information below for the entity(s) (see instructions). (Attach additional sheets, if necessary.)

a Type of entity ................ El Partnership [J Trust [] Partnership [J Trust

Lii S cornoration El Foreian [II] S corooration [ii] Foreian

bName

jo- WILLETT SELECT INVESTORS (TAX JEXEMPT) I LPc Employer Identification number (EIN), if known

2 6-163 43 08d Date Schedule K-i received from entity (enter

'none if Schedule K-i not received) e- 1 09/15/2013Enter below the name and address of each individual or entity to whom you paid a fee with regard to the transaction if that individual or entity promoted, solicited, or


Name I Identifying number (if known) I Fees paid



b Name

Identifying number (if known) Fees paid

$



LI-IA For Paperwork Reduction Act Notice, see separate instructions. Form 8886 (Rev. 3-2011)

13917171111 737725 BLOOMFMFND 2012.04040 THE BL100MBERG FAMILY FOUNDA BLOOMFA2

6

a

THE BLOOMBERG FAMILY JNDATION INC 20-5602483

F= 8886 (Rev. 3-2011)

Page

7 Facts


LJ Deductions Exclusions from gross income Absence of adjustments to basis EJ Tax Credits

Capital loss EJ Nonrecognition of gain Deferral

FYI Ordinary loss fl Adjustments to basis Other

b Further describe the amount and nature of the expected tax treatment and expected tax benefits generated by the transactIon for all affected years. Include facts of

each step of the transaction that relate to the expected tax benefits Including the amount and nature of your investment Include in your description your




Identify afl individuals and entities involved in the transaction that are tax-exempt, foreign, or related. Check the appropriate box(es) (sea instructions). Include their

name(s), identifying number(s), address(es), and a brief description of their Involvement. For each foreign entity, identify its country of incorporation or existence. For


a Type of individual or entity: Tax-exempt Foreign [IJ Related

Name

Identifying number

Address

Description


Related

Name

Identifying number

Address

Description

05-01-12 Form 8886ne. 3-2011)


8886

Reportable Transaction Disclosure Statement

(Rev. March 2011) .Attach to your tax return.

Oepatment of the T See separate Instructions.



OMB No, 1545-1800


Identifying number

20-5602483Number, street and room or suite no. I City or town, state, and ZIP code

C/O GELLIER & CO, 909 THIRD AVE. NO. 16 PEW YORK, NY 10022A If you are filing more than one Form 8886 with your tax return, sequentially number each Form 8886 and enter the statement number

for this Form 8886 ...................................... Statement number 4 of 4B Enter the form number of the tax return to which this form is attached or related 7777 jo. 990 PF

Enter the year of the tax return identified above

*

2012Is this Form 8886 being filed with an amended tax return? ................................................................................................ o. Li Yes LXJ No

C Check the box(es) that apply (see instructions). LXJ Initial year filer L.J Protective disclosure

1 a Name of reportable transaction




a E1 Listed c Contractual protection e Transaction of interest

b El Confidential d EXI Loss

3 If you checked box 2a or 2e, enter the published guidance number for the listed transactionor transaction of interest 00.

4 Enter the number of 'same as or substantially similar transactions reported on this form.


information below for the entity(s) (see instructions). (Attach additional sheets, if necessary.)

a Type of entity El Partnership El Trust I El Partnership El Trust

El S corporation El Foreign I El S corporation El Foreign

b Name



none' If Schedule K-i not received) ............ .

Enter below the name and address of each individual or entity to whom you paid a fee with regard to the transaction if that individual or entity promoted, solicited, or


Name I Identifying number (if known) I Fees paid



Name




LHA For Paperwork Reduction Act Notice, see separate instructions. Form 8806(Rey.3-2011)


I

II

THE BLOOMBERG FAMILY r.JNDATION INC 20-5602483

Form 8886 (Rev. 3.2011) Page 2

7 Facts


El Deductions El Exclusions from gross Income L1 Absence of adjustments to basis El Tax Credits

El Capital loss c:i Nonrecognition of gain El Deferral

IX] Ordinary loss LJ Adjustments to basis El Other

b Further describe the amount and nature of the expected tax treatment and expected tax benefits generated by the transaction for all affected years. Include facts of

each step of the transaction that relate to the expected tax benefits including the amount and nature of your investment. Include in your description your

participation in the transaction and all related transactions regardless of the year in which they were entered Into. Also, include a description of any tax result




name(s), identifying number(s), address(es), and a brief description of their involvement For each foreign entity, identity its country of incorporation or existence. For


a Type of individual or entity El Tax-exempt El Foreign El Related

Name I Identifying number

Address

Description


Related

Name

Identifying number

Address

Description

05-0rue1-12 Form 8886 (Rev. 3-2011)

14217171111 737725 BLOONFANFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

.

THE BLOOMBERO FAMILY NDATION INC 20-5602483

FORM 8886 PARTICIPATED IN TRANSACTION THROUGH STATEMENT 39ANOTHER ENTITY

TRANSACTION NAME: FOREIGN CURRENCY LOSS PURSUANT TO IRC SECTION 988

TYPE OF ENTITY DATE K-iNAME AND ElM OF OTHER ENTITY PARTNER S CORP TRUST FOREIGN RECEIVED

WILLETT PRIVATE INVESTORS (TAX EXEMPT) X 09/15/2013I LLC26-2359838

THE VARDE FUND IX, LP

Ki

NONE26-1594327



TYPE OF ENTITYNAME AND EIN OF OTHER ENTITY PARTNER S CORP TRUST FOREIGN

WIL1LEPP SELECT INVESTORS (TAX EXEMPT) I XLP26-1634308

DATE K-iRECEIVED

09/15/2013

BAtJPOST VALUE PARTNERS, LP -IV

Ki

NONE26-2208448

143 STATEMENT(S) 39, 4017171111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

THE BLOONBERG FAMILY FIFLTNDATION INC 20-5602483



TYPE OF ENTITY DATE K-iNAME AND EIN OF OTHER ENTITY PARTNER S CORP TRUST FOREIGN RECEIVED

WILLETT SELECT INVESTORS (TAX EXEMPT) I X 09/15/2013LP20-5602483

WILLETT AIV SELECT INVESTORS I LP X NONE26-1633115


No. 1545-0026

AttachmentSequence No.128

US

926(Rev. December 2011)Department of the TreasuryInternet Revenue Service

Part ILJ.S.Ti

Return by a U.S. Transferor of Propertyto a Foreign Corporation

ON-Attach to your income tax return for the year of the transfer or distribution.

Name of transferor

Identifying number (seeTHE BLOOMBERG FAMILY FOUNDATION INC

20-5602483If the transferor was a corporation, complete questions 1 a through 1 d.

a lithe transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 or

fewer domestic corporations?. Yes No

It Did the transferor remain In existence after the transfer? ......................................................................................... EJ Yes EJ NoIf not, list the controlling shareholder(s) and their Identifying number(s):

Controlling shareholder

Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? [Iii Yes Li NoIf not, list the name and employer identification number (EIN) of the parent corporation:

Name of parent corporation

EIN of parent corporation

d Have basis adjustments under section 367(a)(5) been made?L...J Yes

No

2 If the transferor was a partner in a partnership that was the actual transferor (but is not treated as such under section 367), complete

questions 2a through 2d.a Ust the name and EIN of the transferor's partnership:

Name of partnership

EIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pick up its pro rota share of gain on the transfer of partnership assets?

L&l Yes LJNo

c Is the partner disposing of its entire Interest in the partnership? ............................................. ID Yes 1X1 No

d Is the partner disposing of an interest in a limited partnership that is regularly traded on an established

Part II I Transferee Foreign Corpo

3 Name of transferee (foreign corporation)

4 Identifying number, if any

ALG HOLDINGS E.V.5 Address (including country)DE BOELELAAN 71083 HJ AMSTERDAM, NETHERLANDS6 Country code of country of incorporation or organizationNL

7 Foreign law characterization (see instructions)CORPORATION

8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... Li Yes LXJ NoLHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12.2011)22453105-01-12


[k]

LZirForm926(Rev.12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 205602483 Paqe2

I Part Ill I Information Regarding Transfer of Property (see instructions)

Type ofproperty

(a) (b) (c) (d) (e)Date of Description of Fair market value on Cost or other Gain recognized ontransfer I property I dale of transfer I basis I transfer

Stock andsecurities

Installment obligations,account receivables orsimilar property

Foreign currency or otherproperty denominated inforeign currency

Inventory

Assets subject todepreciation recapture(see Temp. Regs. sec.

Tangible property used intrade or business not listedunder another category

Intangibleproperty

Property to be leased(as described in finaland temp. Regs. sec.1.367(a)4(cProperty to be sold(as described inTemp. Regs. sec.1 .367(a)4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.

Other property

Supplemental Information Required To Be Reported (see instructions):

Form 926 (Rev. 12-2011)22453205-01-12

14617171111 737725 BLOOMFNFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

Elf 1A


20-5602483

9 Enter the transferor's interest in the foreign transferee corporation before and after the transfer

(a) Before % (b) After

10 Type of nonrecognition transaction (see instructions) SECTION 351 TRANSACTION

11 Indicate whether any transfer reported in Part III is subject to any of the following:

a Gain recognition under section 904(0(3) El Yes [] No

b Gain recognition under section 904(f)(5)(F) EJ Yes [I] No

c Recapture under section 1503(d) EJ Yes EM Nod Exchange gain under section 987 . Yes EJ No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? El Yes [] No

13 Indicate whether the transferor was required to recognize income under final and temporary Regulations sections1.367(a)-4 through 1.367(a)-6 for any of the following:

a Tainted property El Yes IX] Nob Depreciation recapture El Yes [] No

c Branch loss recapture El Yes EXI No

d Any other Income recognition provision contained in the above-referenced regulations El Yes [] No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? El Yes EM No

15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section

1 .367(a)-i T(d)(5)(iii)? El Yes LJ No

b If the answer to line 15a is 'Yes," enter the amount of foreign goodwill or going concern valuetransferred $

16 Was cash the only property transferred? .Yes El No

17a Was intangible property (within the meaning of section 936h)(3)(B)) transferred as a result of the transaction? El Yes No

b if 'Yes,' describe the nature of the rights to the intangible property that was transferred as a result of thetransaction:

Form 926 (Rev. 12-2011)

22453305-01-12




Attach to your Income tax return for the year of the transfer or distribution.AttathmentSequence No. 128

Name of transferor Identifying number (see lflSbUCffOflS)

THE BLOOMBERG FAMILY FOUNDATION INC20-5602483

If the transferor was a corporation, complete questions 1 a through 1 d.a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 or

fewer domestic corporations? ................................................................................................................................. LIIJ Yes EJ Nob Did the transferor remain inexistence after the transfer? ................................................................................ L1J Yes No

If not, list the controlling shareholder(s) and their identifying number(s):


Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was It the parent corporation? ......... L_J Yes L..J No

If not, list the name and employer identification number (EIN) of the parent corporation:



d Have basis adjustments under section 367(a)(5) been made? 1_i Yes

No

2 If the transferor was a partner in a partnership that was the actual transferor (but Is not treated as such under section 367), completequestions 2a through 2d.

a Ust the name and EIN of the transferor's partnership:

Name of partnership

EIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC L26-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LXJ Yes U No

c Is the partner disposing of its entire interest in the partnership? £11 Yes IXJ Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established -




BC LUXCO MIDCO SRL 98-10856525 Address (including country)9A, RUE GABRIEL LIPPMANNMUNSBACH, L-5365 LUXEMBOURG6 Country code of country of incorporation or organizationLU


8 Is the transferee forei gn corporation a controlled foreign corporation? ..................................................................... Li Yes LXJ NoLHA For Paperwork Reduction Act Notice, see separate Instructions. Form 926 (Rev. 12-2011)22453105-01-12

14817171111 737725 BLOOMFMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

Form 926 (Rev. 12 •2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602433 Page 2I Part III I Information Regarding Transfer of Property (see instructions)

(a) (b) (c) (d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer I property date of transfer basis transfercasi, 12/04/2012 155,741.

Stock andsecurities


Foreign currency or otherproperty denominated Inforeign currency

Inventory

Assets subject todepreciation recapture(see Temp. Regs. sec.1 .367(a).4T(b))Tangible property used intrade or business not listedunder another category

Intangibleproperty

Property to be leased(as described in finaland temp. Regs. sec.

Property to be sold(as described InTemp. Regs. sec.1 .367(a)4T(d))Transfers of oil and gasworking interests (asdescribed In Temp.

Other property

Supplemental Information Required To Be Reported (see Instructions):

224532 Form 926 (Rev. 12.2011)05-01-12


THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483

9 Enter the transferor's Interest in the foreign transferee corporation before and after the transfer



11 Indicate whether any transfer reported in Part Ill is subject to any of the following:

a Gain recognition under section 904(t)(3) EJ Yes Nob Gain recognition under section 904(t)(5)(F) El Yes FX7 No

c Recapture under section 1503(d) El Yes M No

d Exchange gain under section 987 0 Yes [Z] No

12 Did this transfer result from a change In the classification of the transferee to that of a foreign corporation? El Yes [J No


a Tainted property Lii] Yes CJ Nob Depreciation recapture U Yes IJl Noc Branch loss recapture ........................................................................................................................... El Yes [XI No

d Any other income recognition provision contained in the above-referenced regulations El Yes EIXI No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? ............ U Yes EL No

15 a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section

1.367(a)-i T(d)(5)(iii)? El Yes LXI No

b If the answer to line 15a is Yes," enter the amount of foreign goodwill or going concern valuetransferred $

16 Was cash the only property transferred? [XI Yes El No

17 a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? ED Yes No

b If Yes, describe the nature of the rights to the intangible property that was transferred as a result of thetransaction:

Form 926 (Rev. 12-2011)

2245305-01-12


OMB No. 1545-0026


Name of transferorTHE BLOOMBERG FAMILY FOUNDATION INC

Identifying number (stelrtstrrjctjons)

1i 3926

(Rev. December 2011)Department of the TreasuryInternal Revenue Service


'Attach to your income tax return for the year of the transfer or distribution.

20-5602483If the transferor was a corporation, complete questions 1 a through 1d.

a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 orfewer domestic corporations? . Yes No

b Did the transferor remain in existence after the transfer? . Yes NoIf not, list the controlling shareholder(s) and their Identifying number(s)

Controlling shareholder Identifying number

C If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? Li Yes L..J iiIf not, list the name and employer identification number (EIN) of the parent corporation:

Name of parent corporation EIN of parent corporation

d Have basis adjustments under section 367(a)(5) been made? L.J Yes

No

2 If the transferor was a partner in a partnership that was the actual transferor(but is not treated as such under section 367), completequestions 2a through 2d.


Name of partnership EIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? Lxi Yes U NoC Is the partner disposing of its entire interest in the partnership? .Yes [] Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established

securities market? Yes L] NoPart II J Transferee Foreign Corpo


BRAVISSIMA5 Address Cincluding country)P.O. BOX 270, 851 04 SUNDSVALLSTOCKHOLM lAN, STOCKHOLM KOMUN, SWEDEN6 Country code of country of Incorporation or organizationSW


8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... LJ Yes LXJ NoLHA For Paperwork Reduction Act Notice, see separate Instructions. Form 926 (Rev. 12-2011)22453105-01-12



Form 926(Rev.12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 205602483 PaqI Part Ill J Information Regarding Transfer of Property (see Instructions)

Type ofproperty

(a) (b) (c) (d) (e)Date of Description of Fair market value on Cost or other Gain recognized ontransfer property I date of transfer - basis I transfer

Stock andsecurities



Inventory



Intangibleproperty

Property to be leased(as described in finaland temp. Regs. sec.1.367(a)-4(c))Property to be sold(as described inTemp. Regs. sec.1 .367(a)-4T(d))Transfers of oil and gasworking Interests (asdescribed in Temp.

Other property


224532 Form 926 (Rev. 12-2011)05-01-12


1#1THE

FAMILY FOUNDATION INC

20-5602483

9 Enter the transferor's interest in the foreign transferee corporation before and after the transfer.

(a) Before % (b) After - %

10 Type of nonrecognition transaction (see Instructions) SECTION 351 TRANSACTION

11 Indicate whether any transfer reported In Part III is subject to any of the following:

a Gain recognition under section 904(t)(3) El Yes [J No

b Gain recognition under section 904(f)(5)(F) E1 Yes [Xl No

c Recapture under section 1503(d)i:i Yes [Xi Nod Exchange gain under section 987 . Yes No

12 Did this transfer result from a change In the classification of the transferee to that of a foreign corporation? El Yes [Xl No

13 Indicate whether the transferor was required to recognize income under final and temporary Regulations sections1.367(a)4 through 1.367(a)-6 for any of the following:

a Tainted property LI Yes [Xl Nob Depreciation recapture i::i Yes EE No

c Branch loss recapture El Yes [Xi No

d Any other income recognition provision contained in the above-referenced regulations El Yes LX] No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? LI Yes LJ No


1 .367(a)-i T(d)(5)(ii? El Yes No

b If the answer to line 15a is "Yes," enter the amount of foreign goodwill or going concern valuetransferred $

16 Was cash the only property transferred? LX] Yes El No

17 a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? El Yes [Xl No

b If 'Yes, describe the nature of the rights to the intangible property that was transferred as a result of thetransaction:

Form 926 (Rev. 12-2011)

22453305-01-12


No. 1545-0026


JAJ

926(Rev. December 2011)Department or the TreasuryInternal Revenue Service


10-Attach to your income tax return for the year of the transfer or distribution.


Identifying

20-5602483If the transferor was a corporation, complete questions la through 1d.


b Did the transferor remain in existence afterthe transfer? LJ Yes NoIf not, list the controlling shareholder(s) and their identifying number(s):


c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? L..J Yes L....J NoIf not, list the name and employer identification number (EIN) of the parent corporation:



No

2 If the transferor was a partner In a partnership that was the actual transferor (but is not treated as such under section 367), completequestions 2a through 2d.

a List the name and EIN of the transferor's partnership:


WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?

LX] Yes U No

C Is the partner disposing of its entire interest in the partnership?

ElYes [X]Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established

No

3 Name of transferee (foreign corporation) 4 Identifying number, if any

GENPACT LIMITED I 98-05333505 Address (including country)CANON'S COURT, 22 VICTORIA STREETHAMILTON, HM, BERMUDA6 Country code of country of incorporation or organizationBD


8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... LJ Yes [Xi NoLHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)22453105-01-12


CForm 926(Rev.12•2011) THE BLOOMBERG FAMILY FOUNDATION INC 205602483 Page2

I Part III I Information Regarding Transfer of Property (see instructions)

Type ofproperty

(a) (b) (c) (d) (e)Date of Description of Fair market value on Cost or other Gain recognized ontransfer I orooertv I date of transfer I basis I transfer

Stock andsecurities



Inventory

Assets subject todepreciation recapture(see Temp. Regs. sec.1 .367(a)4T(b))Tangible property used intrade or business not listedunder another category

Intangibleproperty

Property to be leased(as described In finaland temp. Regs. sec.

Property to be sold(as described inTemp. Regs. sec.1 .367(a).4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.Recis. sec. 1.367(a)-4T((

Other property


224532Form 926 (Rev. 12-2011)

05-01-12


12-2011) THE BLOOMBERG FAMILY FOUNDATION INC

20-5602483 3

9 Enter the transferor's interest in the foreign transferee corporation before and after the transfer:


10 Type of nonrecognition transaction (see instructions) 11o. SECTION 351 TRANSACTION

11 Indicate whether any transfer reported in Part III is subject to any of the following:a Gain recognition under section 9O4(tX3) E1] Yes LX] Nob Gain recognition under section 904(1)(5)(F) El1 Yes EM NoC Recapture under section 1503(d) Eli Yes LX] Nod Exchange gain under section 987 .Yes LX] No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? El Yes LXI No


a Tainted property El Yes LX] Nob Depreciation recapture El Yes []J NoC Branch loss recapture El Yes IlIXI Nod Any other income recognition provision contained in the above-referenced regulations El Yes LI No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? El Yes

15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section1 .367(a)-i T(d)(5)(iii)? El] Yes

b If the answer to line 15a is "Yes, enter the amount of foreign goodwill or going concern valuetransferred 111o. $

11X] No

LXI No


17a Was Intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? El Yes IM No

b If Yes," describe the nature of the rights to the intangible property that was transferred as a result of thetransaction:

Form 926 (Rev. 12-2011)

22453305-01-12

15617171111 737725 BLOOMF2MFND 2012.04040 THE BLOOMBERG FAMILY FOtJNDA BLOOMFA2

1i926

(Rev. December 2011)IDepeirnent of the TreasuryInternal Revenue Service


10,Attach to your income tax return for the year of the transfer or distribution.


OMB No. 1545-0026


Identifying number (see inshcgons)

20-5602483If the transferor was a corporation, complete questions la through 1 d.

a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 or

fewer domestic corporations? El Yes El Nob Did the transferor remain inexistence after the transfer? ..........................................................................................EJ Yes El No

If not, list the controlling shareholder(s) and their Identifying number(s):


Identifying number

o If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L.....J Yes L...J NoIf not, list the name and employer identification number (EIN) of the parent corporation:



d Have basis adjustments under section 367(a)(5) been made? L.__J Yes

No


questions 2a through 2d.


Name of partnership

EIN of partnership


26-2359838b Did the partner pickup its pro rata share of gain on the transfer of partnership assets?

LXJ v _L_TNo

o Is the partner disposing of its entire interest In the partnership?

L:Jves LlNod Is the partner disposing of an interest in a limited partnership that Is regularly traded on an established

Part II I Transferee Foreign Corporation Information3 Name of transferee (foreign corporation)


ACECO TI5 Address (including country)AV. DAS NACOES UNIDAS, LL633-12 .ANDAR, BROOKLIN NOVOCEP 04578-000, SAO PAULO - SP BRAZIL6 Country code of country of incorporation or organizationBR


8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... Li Yes LX] NoLI-IA For Paperwork Reduction Act Notice, see separate instructions. Form 826 (Rev. 12.2011)22453105.01-12


Fomi926(Rev.12.2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Page2


(a) (b) (C) (d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer I property date of transfer basis transfer

03/27/20121 257,469.

Stock andsecurities



Inventory

Assets subject todepreciation recapture(see Temp. Regs. sec.1 .367(a)-4T(b))Tangible property used intrade or business not listedunder another category

Intangibleproperty

Property to be leased(as described in finaland temp. Regs. sec.1 .367(a)4(c))Property to be sold(as described inTemp. Regs. sec.

Transfers of oil and gasworking interests (asdescribed in Temp.Reos. sec. 1 .367(al-4Tft

Other property


224532Form 926 (Rev. 12-2011)

05-01-12

15817171111 737725 BLOOMFNFND 2012.04040 THE BLOOMBERG FAMILY FOtThDA BLOOMFA2

EA

[ATHE BLOOMBERG FAMILY FOUNDATION INC 20-5602483

8 Enter the transferor's Interest In the foreign transferee corporation before and after the transfer



11 Indicate whether any transfer reported In Part III is subject to any of the following:

a Gain recognition under section 904(f)(3) ................................................................................................................... Yes LX] Nob Gain recognition under section 904(f)(5)(F) . Yes LX] Noc Recapture under section 1503(d) . Yes LX] Nod Exchange gain under section 987 . Yes iJJ No

12 Did this transfer result from a change In the classification of the transferee to that of a foreign corporation? E] Yes LX] No


a Tainted property . Yes LX] No

b Depreciation recapture LJ Yes LX] Noc Branch loss recapture . Yes LXJ No

d Any other income recognition provision contained In the above-referenced regulations U Yes 1XI No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? U Yes LX] No


1 .367(a)-i T(d)(5)(ii? U Yes No

b If the answer to line 15a is "Yes," enter the amount of foreign goodwill or going concern valuetransferred 10, $

16 Was cash the only property transferred? LXJ Yes U No

17 a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? U Yes LX] No

b If "Yes," describe the nature of the rights to the intangible property that was transferred as a result of thetransaction:

Form 926 (Rev. 12-2011)

22453305-01-12

15917171111 737725 BIJOONFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOONFA2

14

I AlForm 926(Rev. December 2011)Department of the TreasuryInternal Revenue Service


01, Attach to your income tax return for the year of the transfer or distribution. AttachmentSequence No. 128

Name of transferor

Identifying number (senlnstiucttons)


If the transferor was a corporation, complete questions 1 a through id.a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 or

fewer domestic corporations? . Yes Nob Did the transferor remain In existence after the transfer? . Yes Ell No

If not, list the controlling shareholder(s) and their identifying number(s)


Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L......J Yes L..J NoIf not, list the name and employer identification number (EIN) of the parent corporation:


E1N of parent corporation

d Have basis adjustments under section 367(a)(5) been made" Li Yes

No

2 If the transferor was a partner in a partnership that was the actual transferor (but is not treated as such under section 367), completequestions 2a through 2d.


Name of partnership

EIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pick up its pro rats share of gain on the transfer of partnership assets? LAJ Yes L_J Noc Is the partner disposing of its entire Interest in the partnership? . Yes IIJ Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established

securities market? Yes EJ Noart II I Transferee Foreicin Corooration Information (see Instructions)



AXEL I5 Address (including country)AXEL-SPRINGER-STRABE 6510888 BERLIN, GERMANY6 Country code of country of incorporation or organizationGM

7 Foreign law characterization (see Instructions)CORPORATION

8 Is the transferee foreign corporation a controlled foreign corporation? ................................................ ..................... U Yes LXJ NoLHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)22453105-01-12


Type ofproperty

Cash

Stock andsecurities


ri Regarding Transfer of Property (see instructions)

(a) (b) (c)Date of Description of Fair market value ontransfer I orooertv I date of transfer

20-5602483

(d) (e)Cost or other Gain recognized on

basis I transfer

Instatment obligations,account receivables orsimilar property


Inventory


Intangibleproperty

Property to be leased(as described in finaland temp. Regs. sec.1 .367(a)-4(c))Property to be sold(as described inTemp. Regs. sec.

1 .367(a)4T(d))Transfers of oil and gasworking interests (asdescribed In Temp.Regs. sec. 1 .367(a)-4T(

Other property


224532Form 926 (Rev. 12.2011)

05-01-12

16117171111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA ELOOMFA2

Form 926 (Rev. 12-2011) THE BIOOMBERG FAMILY FOUNDATION INC 205602483 Page3[Part IV J Additional Information Regarding Transfer of Property (see Instructions)

9 Enter the transferors interest in the foreign transferee corporation before and after the transfer

(a) Before % (b) After %


11 indicate whether any transfer reported In Part III is subject to any of the following:

a Gain recognition under section 904(f)(3). Yes [X] Nob Gain recognition under section 904(f)(5)(F) . Yes IXJ Noc Recapture under section 1503(d) . Yes [X] No

d Exchange gain under section 987 . Yes IXI No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? . Yes EU No

13 Indicate whether the transferor was required to recognize income under final and temporary Regulations sections1 367(a) .4 through 1 367(a)-6 for any of the following:

aTainted property .................................................................................................................................................... Yes EE Nob Depreciation recapture .Yes [I] Noc Branch loss recapture .Yes IM Nod Any other income recognition provision contained in the above-referenced regulations . Yes E2 No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? EJ Yes EXJ No

15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations sectionL367(a)-1T(d)(5)(iii)? . Yes EJ No

b If the answer to line 15a is Yes, enter the amount of foreign goodwill or going concern valuetransferred $

16 Was cash the only property transferred? .Yes No

17a Was intangible property (within the meaning of section 936(h)(3))) transferred as a result of the transaction? Yes L3 No

b if Yes, describe the nature of the rights to the intangible property that was transferred as a result of thetransaction:

Form 926 (Rev. 12-2011)

22453305-01-12

16217171111 737725 ELOOMFNFND 2012.04040 THE BTJOOMBERG FAMILY FOUNDA BLOOMFA2

1^

EA

926

Return by a U.S. Transferor of Property(Rev. December 20 11)IDepatment ot the TreasuryInternet Revenue Service


to a Foreign Corporation

Name of transferor -THE BLOOMBERG FAMILY FOUNDATION INC

OMB No. 1545-0026 -

AttachmentSequence No.

Identifying number (see tflSfrUCQflS)



fewer domestic corporations? .Yes Nob Did the transferor remain in existence after the transfer? .Yes No



Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? L.J 's U NoIf not, list the name and employer identification number (EIN of the parent corporation:


E1N of parent corporation

d Have basis adjustments under section 367(a)(5) been made? ................................................................................. L__J Yes

No



Name of partnership

EIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 1 26-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? UJ Yes Li No

o Is the partner disposing of its entire interest in the partnership? ....... ... ............

.................. EJ Yes LX] Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established

Part II I Transferee Foreign Corpo3 Name of transferee (foreign corporation)

4 identifying number, if any

KIWI HOLDCO CAYCO, LTD (DBA FNZ)5 Address (including country)

1 TANFIELDEDINBURGH, EH3 5DA, UNITED KINGDOM6 Country code of country of incorporation or organization

UK7 Foreign law characterization (see instructions)CORPORATION

8 Is the transferee foreign corporation a controlled foreign corporation' ..................................................................... Li Yes LXJ NoLHA For Paperwork Reduction Act Notice, see separate instructions Form 926 (Rev. 12-2011)05-01-12


Awk

Form 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 205602483 Page 2Part Ill Information Regarding Transfer of Property (see instructions)

(a) (b) (C) (d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer property date of transfer basis transferCash 03/06/20121 183.634.

Stock andsecurities



Inventory

Assets subject todepreciation recapture(see Temp. Pegs. sec.1 .367(a)4T(b))Tangible property used intrade or business not listedunder another category

Intangibleproperty

Property to be leased(as described in finaland temp. Rags. sec.1.367(a)-4(c))Property to be sold(as described inTemp. Regs. sec.1 .367(a).4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.

Recis. sec. 1 .367(a)-4T(E

Other property


224532 Form 926 (Rev. 12-2011)05-01-12



20-5602483



10 Type of nonrecognition transaction (see instructions) Poo, SECTION 351 TRANSACTION

11 Indicate whether any transfer reported in Part III Is subject to any of the following:

a Gain recognition under section 904(tX3) El Yes EXJ No

b Gain recognition under section 904(l(5)(F) El Yes EXI No

C Recapture under section 1503(d) El Yes Nod Exchange gain under section 987 . Yes LJ No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? El Yes L1 No

13 Indicate whether the transferor was required to recognize Income under final and temporary Regulations sections1.367(a)-4 through 1.367(a)-6 for any of the following:

aTainted property ................................................................................................................................................... Q Yes Nob Depreciation recapture El Yes LJ Noc Branch loss recapture El Yes IJ No

d Any other income recognition provision contained in the above-referenced regulations El Yes EXJ No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? El Yes EJ No


1.367(a)-1T(c)(5)(iii)? El Yes [I No

b If the answer to line 15a is 'Yes,' enter the amount of foreign goodwill or going concern valuetransferred 11o. $

16 Was cash the only property transferred?[] Yes El No

17a Was intangible property (within the meaning of section 936(h)(3)(8)) transferred as a result of the transaction? El Yes [XI No

b If 'Yes,' describe the nature of the rights to the intangible property that was transferred as a result of thetransaction:

Form 926 (Rev. 12-2011)

22453305-01-12


1^ Ias-

F. 926(Rev. December 2011)Department of the TreasuryInternal Revenue Service


'Attach to your income tax return for the year of the transfer or distribution.AttachmentSequence No. 128

Name of transferor

Identifying number (see )flsc)THE BLOOMBERG FAMILY FOUNDATION INC


a if the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 or

fewer domestic corporations? ................................................................................................................................. [l Yes El Nob Did the transferor remain in existence after the transfer? ............ ................ ............................. .. . El Yes [l No



Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? L..J Yes L_J Noif not, list the name and employer Identification number (EIN) of the parent corporation:




No


a List the name and 8W of the transferors partnership:

Name of partnership

EIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 26-2359838

b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LXJ Yes 1......J No

c Is the partner disposing of its entire interest in the partnership? .................................................... El Yes [IJ No

d Is the partner disposing of an Interest in a limited partnership that is regularly traded on an establishedsecurities market? El Yes [] No

Part II I Transferee Foreign Corporation Information (see instructions)

3 Name of transferee (foreign corporation) 1 4 Identifying number, if any

FOURCEE INFRASTRUCTURE EQUIPMENTS PRIVATE LTD.5 Address (including country)432, LAXMI MALL, LAXMI INDUSTRIAL ESTATE, NEW LINK ROAD, ANDHERI (w)MUMBAI 400053, INDIA

6 Country cede of country of Incorporation or organizationIN


8 Is the transferee forei gn corporation a controlled foreign corporation? ...................................................................... Yes LXJ No

LHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)22453105-01-12

16617171111 737725 BLOOMFAMPND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

THE BL100MBERG FAMILY FOUNDATION

20-5602483ri Regarding Transfer of Property (see instructions)

Type ofproperty

(a) (b) (c) (d) (e)Date of Description of Fair market value on Cost or other Gain recognized ontransfer I Drooertv I date of transfer I basis I transfer

Stock andsecurities



Inventory


Intangibleproperty


Property to be sold(as described inTemp. Regs. sec.1 .367(a)-4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.

Other property


224532Form 926 (Rev. 12-2011)

05-01-12

16717171111 737725 ELOOMFAMFND 2012.04040 THE BL100MBERG FAMILY FOUNDA BLOOMFA2

141#12•2011 THE


20-5602483




11 Indicate whether any transfer reported in Part III is subject to any of the following:a Gain recognition under section 904(1)(3) . Yes IX] No

b Gain recognition under section 904(I)(5)(F) E] Yes LX] Noc Recapture under section 1503(d) El Yes LXJ No

d Exchange gain under section 987 . Yes E1 No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? [J Yes [J No

13 Indicate whether the transferor was required to recognize income under final and temporary Regulations sections1367(a)-4 through 1.367(a)-6 for any of the following:

aTainted property .............................................................................................................................................Yes No

b Depreciation recapture El Yes [Xi Noc Branch loss recapture El Yes I]J No

d Any other income recognition provision contained in the above-referenced regulations[] Yes [XI No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? El Yes iJJ No

ISa Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section

1.367(a)-1T(d)(5)(ill)? EJ Yes EXI No

b If the answer to line 15a is "Yes, enter the amount of foreign goodwill or going concern valuetransferred $


17 a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? El Yes Ill No


Form 926 (Rev. 12-2011)

22453305-01-12

16817171111 737725 BLOOMFAMFND 2012.04040 THE BTJOOMBERG FAMILY FOUNDA BLOOMFA2

1#1

F.926(Rev. December 2011)Department of the TreasuryInternal Revenue Service


10,Attach to your income tax return for the year of the transfer or distribution.AttathrnentSequence No. 128

Name of transferor

Identifying number (see Instructions)THE BLOOMBERG FAMILY FOUNDATION INC



b Did the transferor remain in existence after the transfer? . Yes L1J NoIf not, list the controlling shareholder(s) and their identifying number(s):


Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was It the parent corporation?L...J Yes L...J NoIf riot, list the name and employer identification number (EIN) of the parent corporation:



d Have basis adjustments under section 367(a)(5) been made? ........................................ I ........................................ L_J Yes

No


a Ust the name and ON of the transferor's partnership:

Name of partnership

EIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 26-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?L1uJ Yes L...J No

C Is the partner disposing of its entire interest in the partnership? ............................................................................ [1] Yes IM Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established



KLARNA5 Address (including country)NORRA STATIONSGATAN 61113 43 STOCKHOLM, SWEDEN6 Country code of country of Incorporation or organizationSW


B Is the transferee foreign corporation a controlled foreign corporation? .....................................................................L......J Yes [Xi NoLKA For Paperwork Reduction Act Notice, see separate Instructions Form 926 (Rev. 12-2011)05-01-12

16917171111 737725 BLOOMF.ANFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

[E*Im 1#1Form 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Page 2[Part Ill Information Regarding Transfer of Property (see instructions)

Type ofproperty

(a) (b) (c) (d) (e)Date of Description of Fair market value on Cost or other Gain recognized onransfer I property I date of transfer I basis I transfer

Stock andsecurities



Inventory


Intangibleproperty


Property to be sold(as described inTemp. Regs. sec.1 .367(a)-4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.

Other property


224532Form 926 (Rev. 12-2011)

05-01-12

17017171111 737725 BLOONFAMFND 2012.04040 THE BLOOMBERG FAMILY FOtJNDA BLOOMFA2





11 indicate whether any transfer reported in Part lii is subject to any of the following:a Gain recognition under section 904(t)(3) El Yes [X] No

b Gain recognition under section 904(f)(5)(F) [J Yes [I] Noc Recapture under section 1503(d) . Yes [J Nod Exchange gain under section 987 . Yes Ell No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? . Yes iJ No

13 indicate whether the transferor was required to recognize income under final and temporary Regulations sections1.367(a)-4 through 1.367(a)-6 for any of the following:

a Tainted property .Yes [] Nob Depreciation recapture .Yes M NoC Branch loss recapture . Yes i:xi Nod Any other income recognition provision contained in the above-referenced regulations . Yes [J No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? . Yes EJ No

15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section1 .367(a)-i T(d)(5)(ii? . Yes LJ No

b If the answer to line 15a is "Yes," enter the amount of foreign goodwill or going concern valuetransferred" $

16 Was cash the only property transferred? EJ Yes No

17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? Yes [J No

b if"Yes," describe the nature of the rights to the intangible property that was transferred as a result of thetransaction:

Form 926 (Rev. 12-2011)

22453305-01-12


E#

Fcwm 926(Rev. December 2011)Department of the TreasuryInterval Revenue Service

Return by a U.S Transferor of Propertyto a Foreign Corporation



I OMB No. 1545-0026

I AttachmentSequence No. 128

Identifying number (setinthes)


a If the transfer was a section 361(a) or ) transfer, was the transferor controlled (under section 368(c)) by 5 or

fewer domestic corporations?[] Yes Nob Did the transferor remain in existence after the transfer? .Yes No



Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?U] Yes Li NoIf not, list the name and employer identification number (EIND of the parent corporation:



d Have basis adjustments under section 367(a)(5) been made? . - L__J Yes

No



Name of partnership

EIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LZOJ Yes L_J Noc Is the partner disposing of its entire interest in the partnership? .Yes Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established

securitiesmarket" ................................................................................................................................................. Yes No

Part II 1 Transferee Foreign Corporation Information (see Instructions)3 Name of transferee (foreign corporation) 1 4 Identifying number, if any

XIABUXIABU5 Address (including country)P.O. BOX 2681, CRICKET SQUARE, HUTCHINS DRIVEGRAND CAYMAN, KY1-1111, CAYMAN ISLANDS6 Country cede of country of incorporation or organizationCJ


8 Is the transferee foreign corporation a controlled foreign corporation .....................................................................Li Yes LXJ NoLi-lA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12.2011)22453105-01-12


AIN tForm 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Paqe2_

I Part III I Information Regarding Transfer of Property (see Instructions)

(a) (b) (c) (d) (e)Type Of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer I property I date of transfer basis I transfer

Cash

Stock andsecurities



Inventory

Assets subject todepreciation recapture(see Temp. Flegs. sec.


Intangibleproperty

Property to be leased(as described in finaland temp. Regs. sec.1 .367(a)-4(c))Property to be sold(as described InTemp. Regs. sec.1 .367(a)-4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.Reas. sec. 1 .367fa-4T(

Other property


224532Form 926 (Rev. 12-2011)

05-01-12

17317171111 737725 BLOOMFAMFND 2012.04040 THE BLOOM-BERG FAMILY FOUNDA ELOOMFA2

Form 926(Rev.122011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Page3[Part IV I Additional Information Regarding Transfer of Property (see instructions)





a Gain recognition under section 904(f(3) E1 Yes [Xl No

b Gain recognition under section 904(0(5XF) El Yes [Xl Noc Recapture under section 1503(d) El Yes [Xl No

d Exchange gain under section 987 ElI Yes [XI No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? El Yes [Xl No


a Tainted property El Yes [Xl Nob Depreciation recapture El Yes [Xi Noc Branch loss recapture ....................................................................................................................................... El Yes FX1 No

d Any other income recognition provision contained in the above-referenced regulations El Yes LXI No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? El Yes [IX] No

15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section1 .367(a)-i T(d)(5)Qii)? . Yes [XI No

b If the answer to line 1 5a is "Yes," enter the amount of foreign goodwill or going concern valuetransferred $

16 Was cash the only property transferred? [Xl Yes El No

17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? El Yes LXII No


Form 926 (Rev. 12-2011)

22453305-01-12


1iForm 926(Rev. December 2011)Department of the TreasuryInternal Revenue Service




010B No. 1545-0026


Identifying number (see


a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 orfewer domestic corporations? ........................................................................ El Yes EJ No

b Did the transferor remain in existence after the transfer? El Yes El NoIf not, list the controlling shareholder(s) and their identifying number(s):


Identifying number

C If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L...J Yes L_J NoIt not, list the name and employer Identification number (EIN) of the parent corporation:



d Have basis adjustments under section 367(a)(5) been made? .................................................................................L...i Yes

No



Name of partnership

EIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LXJ Yes L..J No

c Is the partner disposing of Its entire interest in the partnership? ............................................ El Yes Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established

. rn.

Part U I Transferee Foreign Corporation Information3 Name of transferee (foreign corporation)


MEDAFE PRTICIPACOES S.A., L,INX S.A. (DBA GRUPO LINX) I5 Address (including country)RUA AUREKIA, NO. 616, SALA 2BAIRRO VILA ROMANA, SAO PAULO, BRAZIL6 Country code of country of incorporation or organizationBR


8 Is the transferee foreign corporation a controlled foreign corporation ? .. .............................................. ..................... L.....l Yes LX] No



Form 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Paq


Type ofproperty

(a) (b) Cc) (d) (e)Date of Description of Fair market value on Cost or other Gain recognized ontransfer I property I date of transfer I basis I transfer

Stock andsecurities

Instanient obligations,account receivables orsimilar property


Inventory


Intangibleproperty

Property to be leased(as described in finaland temp. Regs. sec.1 .367(a)4(c))Property to be sold(as described InTemp. Regs. sec.

Transfers of oil and gasworking interests (asdescribed in Temp.

Other property


Form 926 (Rev. 12-2011)22453205-01-12

17617171111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOtJNDA BLOOMFA2

()

THE BLOOMBERG FAMILY FOUNDATION INC - 20-5602483

9 Enter the transferor's interest In the foreign transferee corporation before and after the transfer:




a Gain recognition under section 904(f)(3) El Yes [Xl Nob Gain recognition under section 904(f)(5)(F) El Yes [XI No

C Recapture under section 1503(d) Yes [Xl Nod Exchange gain under section 987 El Yes iXl No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? El Yes [Xl No


a Tainted property El Yes [XI Nob Depreciation recapture El Yes [XI No

C Branch loss recapture El Yes [Xl No

d Any other income recognition provision contained in the above-referenced regulations El Yes LXI No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? El Yes [Xl No

15a Did the transferor transfer foreign goodwill or going concern value as defined In Temporary Regulations section

1.367(a)-1T(d)(5)(11? El Yes [XI No

b If the answer to line 15a is 'Yes, enter the amount of foreign goodwill or going concern valuetransferred $

16 Was cash the only property transferred? [Xl Yes El No

17 a Was Intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? El Yes FT No

b If 'Yes, describe the nature of the rights to the intangible property that was transferred as a result of thetransaction:

Form 926 (Rev. 12-2011)

22453305-01-12




Attach to your income tax return for the year of the transfer or distribution.


EA

r4102B No. 15-05

achmentquence No.128

lentifying (ste


a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 orfewer domestic corporations?

b Did the transferor remain in existence after the transfer?If not, list the controlling shareholder(s) and their identifying number(s):


Yes

No

U Yes

No

Identifying number

o If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?LJ Yes L__J NoIf not, list the name and employer identification number (EIN) of the parent corporation:


d Have basis adjustments under section 367(a)(5) been made? L_J Yes

No


a List the name and EIN of the transferors partnership:


WILLIETT PRIVATE INVESTORS (TAX EXEMPT) I LL,C 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?

LXJ Yes U No

o Is the partner disposing of its entire interest in the partnership?

U Yes OT Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established

securitiesmarket? ................................................................................................................................................ No


TENFtJ5 Address (including country)2901 BUILDING C, XINGJING COMMERCE CENTERNO, 25 JIAHE ROAD, XI.AMEN CHINA6 Country cede of country of incorporation or organizationCH


8 Is the transferee foreign corporation a controlled foreign corporation? .......................... ........................................... L.J Yes Lxi NoLHA For Paperwork Reduction Act Notice, see separate Instructions. Form 926 (Rev. 12-2011)22453105-01-12


D41

1141Form 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Paqe[Part Ill I Information Regarding Transfer of Property (see Instructions)

Type ofproperty

(a) (b) (c) (d) (e)Date of Description of Fair market value on Cost or other Gain recognized ontransfer I property I date of transfer I basis I transfer

Stock andsecurities



Inventory

Assets subject todepreciation recapture(see Temp. Regs. sac.


Intangibleproperty

Property to be leased(as described in finaland temp. Regs. sec.1 .367(a).4(c))Property to be sold(as described inTemp. Regs. sec.1 .367(a).4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.

Other property


224532Form 926 (Rev. 12.2011)

05-01-12


li

1iF.. 926(Rev. December 2011)Department of the Treasuryintenal Revenue Service



Intormation


Name of transferor

Identifying number is"THE BLOOMBERG FAMILY FOUNDATION INC


a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 orfewer domestic corporations? . Yes EJ No

b Did the transferor remain in existence after the transfer? .Yes [] No



Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? L_J Yes LJ NoIf not, list the name and employer identification number (EIN of the parent corporation:



d Have basis adjustments under section 367(a)(5) been made? L..J No



Name of partnership

EIN of partnership

WIIJLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC

26-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?

I J Yes L.J Noo Is the partner disposing of its entire Interest in the partnership? .............................................................................. ED Yes LXNo




SUNART RETAIL GROUP5 Address (including country)LEVEL 28, THREE PACIFIC PLACE1 QUEEN'S ROAD EAST HONG KONG6 Country code of country of incorporation or organizationHK

7 Foreign law characterization (see instructions)-CORPORATION8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... L.i Yes LXJ No

LHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12.2011)22453105-01-12


Fomi926 (Rev. 122011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Pacie[Part III I Information Regarding Transfer of Property (see instructions)

(a) (b) (c) (d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer property date of transfer basis transferCash 353,263.

Stock andsecurities



Inventory


Intangibleproperty


Property to be sold(as described inTemp. Regs. sec.

Transfers of oil and gasworking interests (asdescribed in Temp.Reps. sec. 1 .367(al-4T(

Other property


224532 Form 926 (Rev. 12-2011)05-01-12


^ATHE BLOOMBERG FAMILY FOUNDATION INC

Part IV I Additional Information Regarding Transfer of Property (see instructions)9 Enter the transferor's interest in the foreign transferee corporation before and after the transfer:



20-5602483 3


a Gain recognition under section 904(1)(3) El Yes Nob Gain recognition under section 904(f)(5)(F) El Yes Ill No

C Recapture under section 1503(d) El Yes [Xi Nod Exchange gain under section 987 El Yes EXI No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? El Yes El No


a Tainted property El Yes [] Nob Depreciation recapture El Yes [XI No

c Branch loss recapture El Yes Nod Any other income recognition provision contained In the above-referenced regulations El Yes I]J No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? El Yes L] No


1.367(a)-1T(d)(5)(ii? El Yes IJJ No

b if the answer to line 15a is "Yes," enter the amount of foreign goodwill or going concern valuetransferred 11o. $


17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? El Yes [l No


Form 926 (Rev. 12-2011)

22453305-01-12

18017171111 737725 BLOOMFAMFND 2012.04040 THE BLOONBERG FAMILY FOUNDA BIJOOMFA2

I i N41


20-5602483

9 Enter the transferors interest in the foreign transferee corporation before and after the transfer.



11 Indicate whether any transfer reported in Part Ill is subject to any of the following:a Gain recognition under section 904(t)(3) . Yes 11 Nob Gain recognition under section 904(1)(5)(F) . Yes {]J Noc Recapture under section 1503(d) . Yes [J Nod Exchange gain under section 987 . Yes LJ No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? [11 Yes [It] No


a Tainted property . Yes EM Nob Depreciation recapture .Yes E]] NoC Branch loss recapture . Yes Nod Any other income recognition provision contained in the above-referenced regulations - Yes IJJ No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? LIII Yes [J No

15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section1 .367(a)-i T(d)(5)(iii)? .Yes No


16 Was cash the only property transferred? LJ Yes No

17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? Yes EK No


Form 926 (Rev. 12-2011)

22453305-01-12

18317171111 737725 BLOOMFAMFND 2012.04040 THE ELOOMBERG FAMILY FOUNDA BLOOMFA2

EA

F. 926(Rev. December 2011)Department of the TreasuryIntemal Revenue Service



OMB No, 1545-0026


Name of transferor

Identifying number (see Ifl$U5)THE BL300MBERG FAMILY FOUNDATION INC


a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 orfewer domestic corporations? .Yes 0 No

b Did the transferor remain in existence after the transfer? L] Yes D NoIf not, list the controlling shareholder(s) and their identifying number(s):


Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L.....J Yes - L..J NoIf not, list the name and employer identification number (EIN) of the parent corporation:



d Have basis adjustments under section 367(a)(5) been made? ...................................................... L.J Yes

No


a LIst the name and EIN of the transferors partnership:

Name of partnership

EIN of partnership


26-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?c Is the partner disposing of its entire interest in the partnership?d Is the partner disposing of an interest in a limited partnership that is regularly traded on an established

Information3 Name of transferee (foreign corporation)

LXJ Yes LJ NoED Yes LJNo


STUDIO MODERNA HOLDINGS B.V.5 Address (Including country)SM HEADQUARTERS, FERRUCCIO PELLI 136900 LUGANO, NETHERLANDS6 Country code of country of incorporation or organizationNL


8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... L..i Yes LXJ NoLHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)22453105-01-12


Fomi92641ev.12-2011) THE BLIOONBERG FAMILY FOUNDATION INC 205602483 Page2I Part Ill I Information Regarding Transfer of Property (see instructions)

(a) (b) (c) (d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty - - transfer property date of transfer basis I transferCash

Stock and

securities

Installment obligations,

account receivables orsimilar property

Foreign currency or other

property denominated inforeign currency

Inventory

Assets subject todepreciation recapture

(see Temp. Regs. sec.

1 .367(a)-4T(b))

Tangible property used in

trade or business not listedunder another category

Intangibleproperty

Property to be leased(as described In final

and temp. Regs. sec.

Property to be sold

(as described in

Temp. Regs. sec.1 .367(a)-4T(d))


Recis. sec. I .367(a4T(

Other property


224532 Form 926 (Rev. 12.2011)05-01-12

18517171111 737725 BLOOMF.MFND 2012.04040 THE BLOONBERG FAMILY FOUNDA BLOOMFA2





11 Indicate whether any transfer reported in Part Ill Is subject to any of the following:a Gain recognition under section 904(f){3) . Yes No

b Gain recognition under section 904(f)(5)(F). Yes EJ NoC Recapture under section 1503(d) . Yes El] Nod Exchange gain under section 987 .Yes Eli No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? . Yes EE No


a Tainted property E] Yes EE Nob Depreciation recapture .Yes liii Noo Branch loss recapture .Yes 1X1 Nod Any other income recognition provision contained In the above-referenced regulations . Yes CX] No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? . Yes EJ No

iSa Did the transferor transfer foreign goodwill or going concern value as defined In Temporary Regulations section1 .367(a)-i T(d)(5)(iii)? . Yes [IJ No

b If the answer to line 15a is "Yes,' enter the amount of foreign goodwill or going concern valuetransferred $

16 Was cash the only property transferred? CX] Yes No

17a Was Intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? L] Yes I]J No

b If "Yes, describe the nature of the rights to the intangible property that was transferred as a result of thetransaction:

Form 926 (Rev. 12-2011)

22453305-01-12


[A]926

(Rev. December 2011)Department of the TreasuryInternal Revenue SeMce




OMB No. 1545-0026


Identifying

20-5602483If the transferor was a corporation, complete questions 1 a through Id.

a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 orfewer domestic corporations? . Yes EJ No

b Did the transferor remain in existence after the transfer? [:]Yes E] NoIf not, list the controlling shareholder(s) and their identifying number(s):


Identifying number

O If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? L_J Yes LJ NoIf not, list the name and employer identification number (EIN) of the parent corporation:



d Have basis adjustments under section 367(a)(5) been made? L..J Yes

No



Name of partnership

EIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pickup its pro rata share of gain on the transfer of partnership assets?L.J Yes L....J Noc Is the partner disposing of its entire Interest in the partnership? . Yes [XI Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established



PRIVALIA VENTA DIRECTA I5 Address (including country)CALLE LLULL, 113-119BARCELONA, CATALONIA, 08005, SPAIN6 Country code of country of incorporation or organization5?


8 Is the transferee foreign corporation a controlled foreign corporation? .................................................. ................... L.J Yes LX] No



Form 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 PaaI Part Ill I Information Regarding Transfer of Property (see instructions)

(a) (b) (c) (d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer property date of transfer basis transferCash 240.604.

Stock andsecurities

Instament obligations,account receivables orsimilar property


Inventory


Tangible property used Intrade or business not listedunder another category

Intangibleproperty


Property to be sold(as described inTemp. Regs. Sec.1 .367(a)4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.Reqs. sec. 1 .367(a4T(

Other property


224532 Form 926 (Rev. 12-2011)05-01-12

18817171111 737725 BLOOMFFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2


9 Enter the transferor's interest In the foreign transferee corporation before and after the transfer



11 Indicate whether any transfer reported In Part Ill is subject to any of the following:a Gain recognition under section 904(1)(3) . Yes LJ Nob Gain recognition under section 904(f)(5)(F) .Yes No

c Recapture under section 1503(d) LI Yes i:i Nod Exchange gain under section 987 .Yes EJ No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? .Yes [] No


a Tainted property .Yes IX] Nob Depreciation recapture .Yes [I] Noc Branch loss recapture . Yes EJ Nod Any other income recognition provision contained in the above-referenced regulations . Yes EJJ No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? . Yes IIJ No

15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section1.367(a).1T(c(5)(iii)? . Yes LJ No


16 Was cash the only property transferred? EJ] Yes No

17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? Yes No

b If 'Yes," describe the nature of the rights to the intangible property that was transferred as a result of thetransaction:

Form 926 (Rev. 12-2011)

22453305-01-12

18917171111 737725 BLOONF.AMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

No.




20-5602483

Form 926(Rev. December 2011)Department of the TreasuryIntenrei Revenue Service



lithe transferor was a corporation, complete questions 1 a through 1d.


fewer domestic corporations? [11J Yes [1] No

b Did the transferor remain In existence after the transfer?[] Yes EI NoIf not, list the controlling shareholder(s) and their identifying number(s):


c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L....J Yes L...J NoIf not, list the name and employer identification number (EIN) of the parent corporation:


d Have basis adjustments under section 367(a)(5) been made? U Yes

No



Name of partnership [IN of partnership


26-2359838b Did the partner pick up Its pro rata share of gain on the transfer of partnership assets? Lxi Yes U Noc Is the partner disposing of its entire Interest In the partnership? [J Yes EXI Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established

securities market? Yes [J NoPart II I Transferee Foreign Corporation Information (see instructions)3 Name of transferee (foreign corporation) 1 4 Identifying number, if any

KASPERSKY LABS5 Address (including country)

MOSCOW, 123060, RUSSIA6 Country code of country of incorporation or organizationRS


8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... L_J Yes LXI NoLHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)22453105-01-12

19017171111 737725 BLOOMF.AMFND 2012.04040 THE BLOOMBERG FAMILY FOTJNDA BLOOMFA2

CForm 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Page


(a) (b) (C) (d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer I property I date of transfer basis I transfer

Cash '-2 1 I •

Stock andsecurities

Installment obligations,account receivables orsini!ar property


Inventory



Intangibleproperty

Property to be leased(as described in final

and temp. Regs. sec.1 .367(a)-4(c))Property to be sold(as described inTemp. Regs. sec.1 .367(a).4T(d))Transfers of oil and gasworking Interests (asdescribed in Temp.Reos. sec. 1 .367(a)-4T(

Other property


224532Form 926 (Rev. 12-2011)

05-01-12


THE BLOOMBERG FAMILY

ON INC

20-560248

9 Enter the transferor's Interest in the foreign transferee corporation before and after the transfer:


10 Type of nonrecognition transaction (see instructions) Do. SECTION 351 TRANSACTION


a Gain recognition under section 904(f)(3) El Yes tJJ No

b Gain recognition under section 904(f)(5)(F)[I] Yes EX] Noc Recapture under section 1503(d) ...........................................................................................................................LJ Yes XI No

d Exchange gain under section 987 El Yes Ill No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation?U Yes [J No


a Tainted property[l Yes [1 Nob Depreciation recapture ................................................................................El Yes [I] NocBranch loss recapture ......................................................................................................................................[l Yes LXI] Nod Any other income recognition provision contained in the above-referenced regulations UI] Yes [XI] No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)?El Yes IXJ No


1.367(a)-i T(d)(5)(iii)?i:i Yes [Xl No

b If the answer to line 1 5a is Yes, enter the amount of foreign goodwill or going concern valuetransferred $

16 Was cash the only property transferred? [IX] Yes El No

17a Was intangible property (within the meaning of section 936h)(3)(B)) transferred as a result of the transaction? -------- El Yes No


Form 926 (Rev. 12-2011)

22453305-01-12


2926

(Rev. December 2011)Department of the TreasuryInternal Revenue Service




1 If the transferor was a corporation, complete questions 1 a through 1 d. --a If the transfer was a section 361 (a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 or

fewer domestic corporations?It Did the transferor remain in existence after the transfer?



OMB No. 1545-0026

AttachmentSequence No. i

Ientifylng number (see jflS)

20-5602483

EJYes EINoL:JYes EJNo

Identifying number

C If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L.....J Yes L.J NoIf not, list the name and employer identification number (EIN) of the parent corporation:




No



Name of partnership

EIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LI Yes L..J Noc Is the partner disposing of its entire interest In the partnership? . Yes EJ Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established




GRUPO DE INVERSIONES STJRibMERICA1A ESPANA, S.L.5 Address (including country)CALLE AYALA, N6628001 MADRID, SPAIN6 Country code of country of incorporation or organizationSP


8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... L..i Yes Lxi NoLHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)22453105-01-12


Form 926(Rev.12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 PaQe2Part Ill I Information Regarding Transfer of Property (see instructions)

Type ofproperty

(a) (b) Cc) (d) (e)Date of Description of Fair market value on Cost or other Gain recognized ontransfer I property I date of transfer I basis I transfer

D

Stock andsecurities



Inventory



Intangibleproperty

Property to be leased(as described in finaland temp. Regs. sec.1.367(a)-4(c))Property to be sold(as described inTemp. Regs. sec.1 .367(a).4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.

Other property


224532 Form 926 (Rev. 12-2011)05-01-12


0 0THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483




11 Indicate whether any transfer reported in Part Ill is subject to any of the following:a Gain recognition under section 904(fX3) . Yes [IX] Nob Gain recognition under section 904(f)(5)(F) . Yes CX] NoC Recapture under section 1503(d) .Yes CX] Nod Exchange gain under section 987 .Yes [IX] No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? . Yes [ix] No


a Tainted property .Yes Nob Depreciation recapture .Yes No

c Branch loss recapture El Yes No

d Any other income recognition provision contained in the above-referenced regulations L1 Yes No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? LJ Yes No


1.367(a)-1T(d)(5)(11? El Yes [X] No

b If the answer to line 1 5a is "Yes, enter the amount of foreign goodwill or going concern valuetransferred $


17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? El Yes l]Il No


Form 926 (Rev. 12-2011)

22453305-el-12

19517171111 737725 ELOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

926(Rev. December 2011)Department of the TreasuryInternal Revenue Service




0MB No. 1545-0026


Identifying number($teIflsbuttofl$)


a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 orfewer domestic corporations? . Yes ED No

b Did the transferor remain in existence after the transfer? .Yes NoIf not, list the controlling shareholder(s) and their identifying number(s):


c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?-. L..J Yes L..J NoIf not, list the name and employer identification number (EIN) of the parent corporation:


d Have basis adjustments under section 367(a)(5) been made? L__i Yes

No




WILLETT PRIVATE INVESTORS TAX EXEMPT) I LLC 26-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?

LXI Yes UN0

c Is the partner disposing of its entire Interest in the partnership? Yes Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established

EE


_______________________

INDTJSIND BANK5 Address (including country)701, SOrITARE CORPORATE BANK, ANDHERI (EAST)MDNBAI 400093, INDIA6 Country cede of country of incorporation or organizationIN


8 Is the transferee foreign corporation a controlled foreign cor poration? ..................................................................... L_J Yes Lxi NoLHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)22453105-01-12


Form 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Paqe2I Part III I Information Regarding Transfer of Property (see instructions)

(a) (b) (C) (d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer property date of transfer basis transfer

Cash 213,561.

Stock andsecurities

Installment obligations,account receivables orsmiler property


Inventory



Intangibleproperty

Property to be leased(as described in finaland temp. Regs. sec.1 .367(a)-4(c))Property to be sold(as described inTemp. Regs. sec.1 .367(a).4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.Reas. sec. 1.367(a)-4T((

Other property


224532Form 926 (Rev. 12.2011)

05-01-12



20-5602483





a Gain recognition under section 904(0(3) El Yes [] No

b Gain recognition under section 904(t)(5)(F) EJ Yes QX No

C Recapture under section 1503(d) EJ Yes [Xl Nod Exchange gain under section 987 El Yes [Xl No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? El Yes DJ No


aTainted property ............................................................................................................. El Yes [XI Nob Depreciation recapture El Yes EK Noc Branch loss recapture El Yes lJ No

d Any other income recognition provision contained In the above-referenced regulations El Yes [J No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? El Yes I]J No


1 .367(a}-1T(d)(5)(iii)? El Yes [J No

b If the answer to line 1 5a is AYes, • enter the amount of foreign goodwill or going concern valuetransferred $


17 a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? El Yes [XI No


Form 926 (Rev. 12-2011)

22452305-01-12

19817171111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOTJNDA BLOOMFA2

1iForm 926(Rev. December 2011)Depaitment of the TreasuryInternal Revenue Service


10,Aftach to your income tax return for the year of the transfer or distribution.


OMB No. 1545-0026


Identifying number (meInsfruc)


a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 orfewer domestic corporations? .Yes No

b Did the transferor remain in existence after the transfer?.

Yes E] No



C If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? L --- J Yes Li NoIf not, list the name and employer Identification number (EIN) of the parent corporation:

Name of parent corporation FIN of parent corporation

d Have basis adjustments under section 367(a)(5) been made? Li Yes Li No



Name of partnership FIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LiJ Yes U No

C Is the partner disposing of its entire interest in the partnership? . Yes EX-1 Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established

Part II I Transferee Foreign Corpo3 Name of transferee (foreign corporation) 4 Identifying number, if any

CITCO III LIMITED5 Address (Including country)89 NEXUS WAY, 2ND FL, CAMANA BAY; P.O. BOX 31106GRAND CAYMAN KY1 -1205, CAYMAN ISLANDS6 Country cede of country of incorporation or organizationC'].


8 Is the transferee forei gn corporation a controlled foreign corporation? .................................................. ....... ............ U Yes LXJ NoLHA For Paperwork Reduction Act Notice, see separate Instructions. Form 926 (Rev. 12.2011)22453105-01.12

19917171111 737725 BLOOMFAMFND 2012.04040 THE BLOO4BERG FAMILY FOUNDA BLOOMFA2

Form 926 (Rev. 122011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Page 2

L Part III I Information Regarding Transfer of Property (see instructions)

(a) (b) (C) (d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer property date of transfer basis transfer

Cash 1 857.757.

Stock andsecurities



Inventory

Assets subject todepreciation recapture(see Temp. Pegs. sec.1 .367(a).4T(b))Tangible property used intrade or business not listedunder another category

Intangibleproperty


Property to be sold(as described inTemp. Regs. sec.1 .367(a)-4T(d))Transfers of oil and gasworking Interests (asdescribed in Temp.

Other property


224532Form 926 (Rev. 12-2011)

05-01-12


omi 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INCPart IV I Additional Information Regarding Transfer of Property (see instructions)9 Enter the transferor's interest in the foreign transferee corporation before and after the transfer.



20-5602483

11 Indicate whether any transfer reported In Part III Is subject to any of the following:

a Gain recognition under section 904(f)(3) EJ Yes 1X1 Nob Gain recognition under section 904(f)(5)(F) .Yes Noc Recapture under section 1503(d) . Yes IJJ Nod Exchange gain under section 987 .Yes 1X1 No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? .Yes EXI No


a Tainted property . Yes EJ Nob Depreciation recapture . Yes EE NocBranch loss recapture .......................................................................................................................................... Q Yes EKJ Nod Any other income recognition provision contained in the above-referenced regulations .Yes [I] No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? .Yes EU No

ISa Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section1 .367(a)-i T(d)(5)(ii? . Yes lJ No

b If the answer to line 15a Is "Yes," enter the amount of foreign goodwill or going concern valuetransferred $


17a Was intangible property (within the meaning of section 936,)(3)(B)) transferred as a result of the transaction? Yes IJJ No


Form 926 (Rev. 12-2011)

22453305-01-12


li _7111111

LA

926(Rev. December 2011)Department of the TreasuryInternet Revenue Service




I OMB No. 1545.0026

AttathmentSequence No. .d

Identifying number (see scuons)

20-5602483If the transferor was a corporation, complete questions la through 1 d.

a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 orfewer domestic corporations? .Yes EJ No

b Did the transferor remain in existence after the transfer? . Yes EIii NoIf not, list the controlling shareholder(s) and their identifying number(s):


c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? L..J Yes =FN,If not, list the name and employer Identification number (EIN) of the parent corporation:


d Have basis adjustments under section 367(a)(5) been made? ................................................................................. L.J Yes

No




WILLETP PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?

LXJ Yes L_J No

C Is the partner disposing of its entire interest In the partnership?

El Yes [X] Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established

Part H I Transferee Foreign Corpo


AEC HOLDINGS LTD.5 Address (including country)303 SHIRLEY STREETP.O. BOX N-492 NASSAU BAHAMAS6 Country code of country of incorporation or organizationBF


8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... LX] Yes Li NoLHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)22453105-01-12

20217171111 737725 BLOONFANFND 2012.04040 THE BLOOMBERG FAMILY FOtJNDA BLOOMFA2

Form 926(Rev.12.2011) THE BLOOMBERG FAMILY FOUNDATION INC 205602483 Paqe2I Part Ill I Information Regarding Transfer of Property (see Instructions)

Type ofproperty

Stock andsecurities

(a) (b) (C) (d) (e)Date of Description of Fair market value on Cost or other Gain recognized ontransfer property date of transfer I basis transfer23/2012 111,471.



Inventory


Intangibleproperty

Property to be leased(as described in finaland temp. Regs. sec.1 .367(a).4(c))Property to be sold(as described inTemp. Regs. sec.1 .367(a)4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.

Other property


224532Form 826 (Rev. 12-2011)

05-01-12

20317171111 737725 BLOOMFNFND 2012.04040 THE BLOONBERG FAMILY FOUNDA BLOOMFA2

1) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483




11 Indicate whether any transfer reported in Part Ill is subject to any of the following:a Gain recognition under section 904(f)(3) . Yes L] No

b Gain recognition under section 904(t)(5)(F). Yes [I] Noc Recapture under section 1503(d) . Yes LXI Nod Exchange gain under section 987 . Yes LX] No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? . Yes EXJ No


a Tainted property .Yes [XI No

b Depreciation recapture EJ Yes LXI NoC Branch loss recapture .Yes LXI Nod Any other income recognition provision contained in the above-referenced regulations .Yes [XI No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? . Yes LXI No


1 .367(a)-i T(c(5)(iii)? El Yes [XI No



17 a Was Intangible property (within the meaning of section 936h)(3)(B)) transferred as a result of the transaction? El Yes [Xl No


Form 926 (Rev. 12-2011)

22453305-01-12


,.926(Rev. December 2011)Department of the TreasuryInternal Revenue Service


bo-Attach to your Income tax return for the year of the transferor distribution.


Hl li

0MB No. 1545-0026


lentitying number (me iflslructtons)

20-5602483If the transferor was a corporation, complete questions la through 1d.


fewer domestic corporations?i:iii Yes No

b Did the transferor remain In existence after the transfer? [TI Yes NoIf not, list the controlling shareholder(s) and their identifying number(s):


c If the transferor was a member of an affiliated group filing a consolidated return, was It the parent corporation? L_J Yes U NoIf not, list the name and employer identification number (EIN) of the parent corporation:


d Have basis adjustments under section 367(a)(5) been made? L_.J Yes

No


a Ust the name and EIN of the transferors partnership:


WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?c Is the partner disposing of its entire interest in the partnership?

d is the partner disposing of an interest in a limited partnership that is regularly traded on an established

LXJ Yes___=NoEl Yes L] No

NoPart II I Transferee Foreign Corpc


PETRUS RESOURCES LTD.5 Address (including country)2400, 240 4TH AVENUE SWCALGARY ALBERTA T2P 1G1 CANADA6 Country code of country of incorporation or organizationCA


8 Is the transferee foreign corporation a controlled foreign corporation? ........................................... .......................... L_J Yes LX] NoLF-{A For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)22453105-01-12


Form 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Page2_I Part III Information Regarding Transfer of Property (see instructions)

Type ofproperty

(a) (b)(0)

(d) (e)Date of Description of Fair market value on Cost or other Gain recognized ontransfer I property I date of transfer I basis I transfer

Stock andsecurities



Inventory


Intangibleproperty

Property to be leased(as described in finaland temp. Regs. sec.11.367(a)-41(c))Property to be sold(as described inTemp. Regs. sec.1 .367(a).4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.Reos. sec. 1.367(a)-4T6

Other property


224532Form 926 (Rev. 12-2011)

05-01-12


Forrn926(Rev.12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 205602483 Page3I Part IV I Additional Information Regarding Transfer of Property (see instructions)



10 Type of nonrecognition transaction (see instructions) u. SECTION 351 TRANSACTION

11 Indicate whether any transfer reported in Part Ill Is subject to any of the following:a Gain recognition under section 904(f)(3) .Yes [] Nob Gain recognition under section 904(t)(5)(F) . Yes [X] Noc Recapture under section 1503(d) .Yes 1X1 Nod Exchange gain under section 987 . Yes [11 No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation?i:i Yes (]1 No


a Tainted property . Yes L1 Nob Depreciation recapture . Yes [XI Noc Branch loss recapture . Yes [J Nod Any other Income recognition provision contained In the above-referenced regulations . Yes EK No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? LJ Yes iJJ No

15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section1 .367(a)-i T(d)(5)(iii)? . Yes [XI No


16 Was cash the only property transferred? EJ Yes E] No

17 a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? Yes MI No


Form 926 (Rev. 12.2011)

22453305-01-12

20717171111 737725 BLOOMF.AMFND 2012.04040 THE BLOOMBERG FAMILY FOtJNDA BLOOMFA2

F.926(Rev. December 2011)Oepadment of the TreasuryIntemal Revenue Service

Part IU.S.Ti


10,Attach to your Income tax return for the year of the transfer or distribution.

0MB No. 1545-0026


Identifying number (sea fl5UCfDfls)



b Did the transferor remain in existence after the transfer?If not, list the controlling shareholder(s) and their identifying number(s):

iniormation (see instructions)Name of transferorTHE BLOOMBERG FAMILY FOUNDATION INC

EJYes NoEJYes No


C If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? L..J Yes - L...J NoIf not, list the name and employer identification number (EIN) of the parent corporation:


d Have basis adjustments under section 367(a)(5) been made? L_..J Yes

No




WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LXJ Yes L..J No

c Is the partner disposing of its entire interest in the partnership? .Yes Nod Is the partner disposing of an Interest in a limited partnership that is regularly traded on an established

',—.- ._securities market? ffl3 Name of transferee (foreign corporation)


ALCHEMY PARTS (IRELAND) LIMITED5 Address (including country)SECOND FLOOR, BEAUX LANE HOUSEMERCER STREET LOWER, DUBLIN 2, IRELAND6 Country code of country of Incorporation or organizationEl

7 Foreign law characterization (see instructions)-CORPORATION

8 Is the transferee forei gn corporation a controlled foreign cor poration? ............................................................. ........Lxi Yes Li NoLHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)22453105-01-12


EA

EAForm 926 (Rev. 12.2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Pacio2I Part III I Information Regarding Transfer of Property (see instructions)

Type ofproperty

(a) (b) (c) (d) (e)Date of Description of Fair market value on Cost or other Gain recognized ontransfer I property I date of transfer I basis I tranfcr

Stock andsecurities



Inventory


Intangibleproperty


Property to be sold(as described inTemp. Regs. sec.I .367(a).4T(d))

Transfers of oil and gasworking interests (asdescribed In Temp.

Other property


224532 Form 926 (Rev. 12.2011)05-01-12


EATHE BLOOMBERG FAMILY FOUNDATION INC 20-5602483

9 Enter the transferor's interest in the foreign transferee corporation before and after the transfer.



11 Indicate whether any transfer reported in Part III is subject to any of the following:a Gain recognition under section 904(f)(3) .Yes [] Nob Gain recognition under section 904(t)(5)(F) . Yes Eli Noc Recapture under section 1503(d) . Yes [J No

d Exchange gain under section 987 E] Yes Eli No

12 Did this transfer result from a change In the classification of the transferee to that of a foreign corporation? .Yes [IX] No


a Tainted property .Yes LX] Nob Depreciation recapture . Yes LX] Noc Branch loss recapture . Yes LXI Nod Any other income recognition provision contained in the above-referenced regulations . Yes LXI No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? . Yes LX] No

15a Did the transferor transfer foreign goodwill or going concern value as defined In Temporary Regulations section1 .367(a)-i T(d)(5)(ii? . Yes LXI No


16 Was cash the only property transferred? LX] Yes No

17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? L1 Yes [XI No


Form 926 (Rev. 12.207)

22453305-01-12

21017171111 737725 BLOOMF2MFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

14Form 926(Rev. December 2011)Department of the TreasuryInternet Revenue Service


Attach to your Income tax return for the year of the transfer or distribution.


i OMB No, 1545-0026

I tahcmentSeAt

quence No. 128

lenifying number (me Inst, us)

20-5602483I If the transferor was a corporation, complete questions 1 a through 1 d. -


fewer domestic corporations? .................................................................................................................................. Yes E1 No

b Did the transferor remain in existence after the transfer? ................................................................................. Yes LJ NoIf not, list the controlling shareholder(s) and their identifying number(s):


Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was It the parent corporation? ...... L.J Yes L......J NoIf not, list the name and employer identification number (EIN) of the parent corporation:




No



Name of partnership

EIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?

LXJ Yes U No

c Is the partner disposing of its entire interest in the partnership? .............................................................................. EJ Yes LXJ Nod Is the partner disposing of an Interest in a limited partnership that is regularly traded on an established



ORIVA AIRLEASE LTD.5 Address (including country)2ND FLOOR BOOTERSTOWN HALL, BOOTERSTOWN AVEBOOTERSTOWN, DUBLIN, IRELAND6 Country code of country of Incorporation or organizationEl


8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... [Xi Yes L..i NoLHA For Paperwork Reduction Act Notice, see separate Instructions. Form 926 (Rev. 12-2011)22453105-01-12


Fons926(Rev.12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 205602483 PageI Part Ill I Information Regarding Transfer of Property (see instructions)

(a) (b) (c) (d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer property date of transfer basis transfercasi, 154,231.

Stock andsecurities



Inventory



Intangibleproperty



Property to be sold(as described inTemp. Regs. sec.1 .367(a).4T(d))Transfers of oil and gasworking Interests (asdescribed in Temp.

Other property


224532 Form 926 (Rev. 12-2011)05-01-12


1#126 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INCIV I Additional Information Regarding Transfer of Property (see instructions




20-5602483

11 Indicate whether any transfer reported In Part Ill is subject to any of the following:a Gain recognition under section 904(f)(3) .Yes Nob Gain recognition under section 904((5)(F) . Yes LX] Noc Recapture under section 1503(d) . Yes LXI Nod Exchange gain under section 987 . Yes LXI No

12 Did this transfer result from a change In the classification of the transferee to that of a foreign corporation? E1J Yes LX] No


a Tainted property[] Yes LX] Nob Depreciation recapture . Yes IXJ Noo Branch loss recapture .Yes LX] Nod Any other income recognition provision contained in the above-referenced regulations . Yes LX] No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? .Yes [XI No

16a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section1 .367(a)-i T(d)(5)(iil)? . Yes LXI No


16 Was cash the only property transferred? LX] Yes U No

17a Was Intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? UI Yes [XI No


Form 926 (Rev. 12-2011)

22453305-01-12

21317171111 737725 BLOONFFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOONFA2

OMB No. 1545.0026


INCName of transferorTHE BLOOMBERG FAMILY FOUNDATION

Identifying number( ins s)

926(Rev. Oecembe( 20 11)Department of the TreasuryInternal Revenue Service





fewer domestic corporations? . Yes El No



o if the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? ......... LJ Yes U NoIf not, list the name and employer identification number (EIN) of the parent corporation:



No




WILLETT PRIVATE INVESTORS (TAX EXEMPT- I LLC 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?c Is the partner disposing of Its entire interest In the partnership?

d Is the partner disposing of an Interest in a limited partnership that is regularly traded on an establishedsecurities market?

LXI _ Yes U__No'El Yes EXI No


PUBLIC HOUSE TRUST5 Address (including country)P.O. BOX 1093, BOUNDARY HALL, CRICKET SQUAREGRAND CAYMAN, KY1-1102, CAYMAN ISLANDS6 Country code of country of incorporation or organizationCJ


8 Is the transferee foreign corporation a controlled foreign corporation? .............................. ....................................... LXJ Yes L.J NoLHA For Paperwork Reduction Act Notice, see separate Instructions. Form 926 (Rev. 12-2011)22453105-01-12


Awk

Form 926(Rev.12-2011) THE BLOONBERG FAMILY FOUNDATION INC 20-5602483 Paqe2I Part Ill I Information Regarding Transfer of Property (see Instructions)

(a) (b) (C) (d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer property date of transfer basis transferCash 93.379.

Stock andsecurities

Instailment obligations,account receivables orsimilar property


Inventory


Intangibleproperty

Property to be leased(as described In finaland temp. Regs. sec.1 .367(a).4(c))Property to be sold(as described inTemp. Regs. sec.1 .367(a)-4T(d))

Transfers of oil and gasworking Interests (asdescribed in Temp.

Other property


224532 Form 926 (Rev. 12-2011)05-01-12

21517171111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOIJNDA BLOOMFA2

THE BT.iOOMBERG FAMILY FOUNDATION INC

20-5602483




11 Indicate whether any transfer reported in Part III is subject to any of the following:a Gain recognition under section 904(f)(3) . Yes [X1 Nob Gain recognition under section 904(0(5)(F) .Yes [] No

c Recapture under section 1503(d) ............................................................................................................................ Yes Ell Nod Exchange gain under section 987 .Yes LXI No

12 Did this transfer result from a change In the classification of the transferee to that of a foreign corporation? ..............Yes EiJ No

13 Indicate whether the transferor was required to recognize income under final and temporary Regulations sections1 .367(a)-4 through 1.367(a)-6 for any of the following:

aTainted property ................................................................................................................................................... Yes [] Nob Depreciation recapture . Yes [J Noc Branch loss recapture LJ Yes E2 Nod Any other income recognition provision contained in the above-referenced regulations . Yes IM No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? .Yes

15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section1 .367(a)-i T(d(5)(ll? .Yes

b If the answer to line 15a is Yes,' enter the amount of foreign goodwill or going concern valuetransferred $

EJNO

JNo

16 Was cash the only property transferred? CX] Yes LJ No

17 a Was intangible property (within the meaning of section 936(h)(3)(13)) transferred as a result of the transaction? Yes 1XI No

b It Yes," describe the nature of the rights to the intangible property that was transferred as a result of thetransaction:

Form 926 (Rev. 12-2011)

22453305-01-12


[A

Form 926ev. December 2011)

Department of the TreasuryInternal Revenue Service


10, Attech to your income tax return for the year of the transfer or distribution.


OMB No. 1545-0026

Attachment reSequence No.1 8

Identifying number(MSbUC)

20-5602483lithe transferor was a corporation, complete questions la through id.

a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 orfewer domestic corporations? Yes E] No



Identifying number

c lithe transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L......J Yes L.J NoIf not, list the name and employer identification number (EIN) of the parent corporation:



d Have basis adjustments under section 367(a5) been made? Li Yes

No



Name of partnership

EIN of partnership

WIL1LETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?

LAJ Yes U No

C Is the partner disposing of its entire interest in the partnership? .................................................................... DYes EXJNo

d Is the partner disposing of an interest in a limited partnership that is regularly traded on an establishedL1 No

Part II I Transferee Foreign Corpc



INVICTA CARD SERVICES HOLDINGS SARL5 Address (including country)6C, RUE GABRIEL LIPPMANNMUNSBACH, L-5365, LUXEMBOURG6 Country code of country of incorporation or organizationLU


8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... LXJ Yes L..J NoLHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)22453105-01-12


tForm 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Pao


(a) (b) (c) (d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer property date of transfer basis transfer

Cash 1 503.556.

Stock andsecurities



Inventory


Intangibleproperty

Property to be leased(as described In finaland temp. Regs. sec.1 .367(a)-4(c))Property to be sold(as described InTemp. Regs. sec.1 .367(a)-4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.

Regs. sec. 1 .367(a)-4T(E

Other property


224532Form 926 (Rev. 12-2011)

05-01-12


12.2011) THE BLOOMBERG FAMILY FOUNDATION INC

20-5602483 Paae3




11 Indicate whether any transfer reported in Part Ill is subject to any of the following:a Gain recognition under section 904(0(3) . Yes [X] Nob Gain recognition under section 904(f)(5)(F) . Yes IJJ NoC Recapture under section 1503(d) . Yes J Nod Exchange gain under section 987 .Yes [] No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? .Yes No


a Tainted property . Yes [Xl Nob Depreciation recapture . Yes IJ NoC Branch loss recapture . Yes EJ Nod Any other income recognition provision contained in the above-referenced regulations . Yes M No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? . Yes EXI No

15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section1.367(a)-i T(d)(5)(iii)? . Yes XI No

b If the answer to line 1 5a Is "Yes,' enter the amount of foreign goodwill or going concern valuetransferred 10- $

16 Was cash the only property transferred? [XI Yes No

17 a Was intangible property (within the meaning of section 936h)(3)(B)) transferred as a result of the transaction? . Yes EXJ No


Form 926 (Rev. 12.2011)

22453305-01-12


2926

(Rev. December 2011)Depelinent of the TreasuryInternal Revenue Service




OMB No. 1545-0026

I AttachmentSequence N.. 128

Identifying number (see jns)


a If The transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 orfewer domestic corporations? . Yes No

b Did the transferor remain in existence after the transfer? .......................................................................................... EJ Yes E1 NoIf not, list the controlling shareholder(s) and their identifying number(s):


Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? L..J Yes L...J NoIf not, list the name and employer identification number (EIN) of the parent corporation:



d Have basis adjustments under section 367(a)(5) been made? ............................................................................... L..J Yes

No



Name of partnership

EIN of partnership

WILLETT PRIVATE INVESTORS (Tax EXEMPT) I LLC 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?

M Yes LJNO

c Is the partner disposing of its entire interest in the partnership?

EIJ Yes I1 Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established



TRENDYOL DSM GRUP D1NISMANHK5 Address (including country)ILETISIM VE SATIS TIC. A. S., AYAZAGA ME. KEMERBURGAZ CDAYAZAGA/SISLI, TURKEY

6 Country code of country of Incorporation or organizationTU


8 Is the transferee foreign corporation a controlled foreign corporation? .......................... ........................................... Lxi Yes Li NoLI-LA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)22453105-01-12


Form 926(Rev.12.2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Paqe2I Part III I Information Regarding Transfer of Property (see Instructions)

(a) (b) (c) (d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer I property I date of transfer basis I transfer

Cash

Stock andsecurities

Installment obligations,account receivables or

similar property


Inventory


Tangible property used Intrade or business not listedunder another category

Intangibleproperty

Property to be leased(as described In finaland temp. Regs. sec.1 .367(a)-4(c))Property to be sold(as described inTemp. Regs. sec.1 .367(a)-4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.

Reqs. sec. 1 .367(a)4T(

Other property


224532Form 926 (Rev. 12-2011)

05-01-12


HETHE BLOOMBERG FAMILY FOUNDATION INC

20-560248





a Gain recognition under section 904(0(3) ..................................................................................................................[1] Yes LX] Nob Gain recognition under section 904(f)(5)(F)[] Yes FRI No

c Recapture under section 1503(d) .Yes LXI Nod Exchange gain under section 987 . Yes LXI No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? . Yes [IX] No

13 Indicate whether the transferor was required to recognize income under final and temporary Regulations sections1.367(a) .4 through 1.367(a) .6 for any of the following:

a Tainted property .Yes EXI No

b Depreciation recapture [II] Yes LX] NoC Branch loss recapture . Yes LXI Nod Any other income recognition provision contained In the above-referenced regulations . Yes LX] No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? . Yes LXI No


1.367(a)-1T(d)(5)(iii)? El Yes No

b If the answer to line 15a is Yes, enter the amount of foreign goodwill or going concern valuetransferred Pop. $


17 a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? El Yes LX] No

b If"Yes," describe the nature of the rights to the intangible property that was transferred as a result of thetransaction:

Form 926 (Rev. 12.2011)

22453305-01-12


HA

EA

F.. 926(Rev. December 2011)Depeilment of the TreasuryIntemal Revenue Service



onName of transferorTHE BLOOMBERG FAMILY FOUNDATION INC

OMB No. 1545-0026


Identifying number(jfl$hUCUOflS)


a if the transfer was a section 361(a) or ) transfer, was the transferor controlled (under section 368(c)) by 5 orfewer domestic corporations? . Yes No

b Did the transferor remain inexistence after the transfer? . Yes NoIf not, list the controlling shareholder(s) and their identifying number(s):


c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? - - L.J Yes L...J NoIf not, list the name and employer identification number (EIN) of the parent corporation:



No




WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC I 26-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LXI Yes L.J No

o Is the partner disposing of Its entire interest in the partnership? .Yes Nod Is the partner disposing of an interest in a limited partnership that Is regularly traded on an established

securities market? El Yes [] No



PEPSCA PTY LTD5 Address Qncluding country)19 AILSA STREET, BOX HILLVICTORIA, 3128, AUSTRALIA6 Country code of country of incorporation or organizationAS


8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... LXI Yes Li NoLI-IA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)22453105-01-12


1i EAForm 926 (Rev. 122011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 PaI Part Ill I Information Regarding Transfer of Property (see instructions)

Type ofproperty

(a) (b) (c)(d) (e)Date of Description of Fair market value on Cost or other Gain recognized ontransfer I property date of transfer basis I transfer

Stock andsecurities

Installment obligations,account receivables orsimar property


Inventory



Intangibleproperty


Property to be sold(as described inTemp. Regs. sec.1 .367(a).4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.

Other property


224532 Form 926 (Rev. 12-2011)05-01-12

22417171111 737725 BLOOMFFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

H]12-2011) THE BLOOMBERG FAMILY FOUNDATION INC

20-5602483





a Gain recognition under section 904(t)(3) E1 Yes [lJ No

b Gain recognition under section 904(f)(5)(F) Li Yes Noc Recapture under section 1503(d) El Yes [] No

d Exchange gain under section 987 El Yes [11 No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corperation? El Yes LJ No


a Tainted property El Yes [I] No

b Depreciation recapture El] Yes [J No

C Branch loss recapture EJ Yes DJ No

d Any other income recognition provision contained in the above-referenced regulations El Yes []] No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? El Yes LJ No

15a Did the transferor transfer foreign goodwill or going concern value as defined In Temporary Regulations section

1 .367(a)-i T(d)(5)(iii)? El Yes IXI No



17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? El Yes EM No


Form 926 (Rev. 12-2011)

22453305-01-12

22517171111 737725 BLOOMF.AMFND 2012.04040 THE ELOOMBERG FAMILY FOUNDA ELOOMFA2

Form 926(Rev. December 2011)Department of the TreasuryIntemal Revenue Service


111 -Attach to your income tax return for the year of the transfer or distribution.


1i

LJ

OMB No. 1545-0026



20-56024831 If the transferor was a corporation, complete questions la through 1d.

a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 orfewer domestic corporations? . Yes c:i No

b Did the transferor remain in existence after the transfer? . Yes EJ NoIf not, list the controlling shareholder(s) and their identifying number(s):


o If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L.....l Yes L......J NoIf not, list the name and employer identification number (EIN) of the parent corporation:


d Have basis adjustments under section 367(a)(5) been made? L.J No




WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LJ Yes L.....i No

c Is the partner disposing of its entire interest in the partnership? . Yes M Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established

securitiesmarket? ................................................................................................................................................. Yes EU Noart II I Transferee Foreign Corporation Information (see instructions



NEW TOPCO PTY LIMITED5 Address (including country)254-294 WELLINGTON ROADMULGRAVE VIC, 3170, AUSTRALIA

6 Country cede of country of incorporation or organizationAS


8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... Lxi Yes L....J NoLHA For Paperwork Reduction Act Notice, see separate Instructions. Form 926 (Rev. 12-2011)22453105-01-12


5-31 19Form 926 (Rev. 12-2011) THE BLOONBERG FAMILY FOUNDATION INC 205602483 PaI Part Ill I Information Regarding Transfer of Property (see instructions)

Type ofproperty

Stock andsecurities

(a) (b) (C) (d (e)Date of Description of Fair market value on Cost or other Gain recognized ontransfer property date of transfer I basis transfer01/2012 675,907.



Inventory



Intangibleproperty

Property to be leased(as described in finaland temp. Regs. sec.1.367(a)-4(c))Property to be sold(as described inTemp. Regs. sec.1 .367(a)-4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.

Other property


224532 Form 826 (Rev. 12.2011)05-01-12

22717171111 737725 BLOOMFAMFND 2012.04040 THE BLOONBERG FAMILY FOUNDA BLOONFA2

orrn 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INCPart IV I Additional Information Regarding Transfer of Property (see instructions)9 Enter the transferor's interest in the foreign transferee corporation before and after the transfer:



20-5602483


a Gain recognition under section 904(0(3) EJ Yes EIJ Nob Gain recognition under section 904(1)(5)(F) - Yes [X] Noc Recapture under section 1503(d) - Yes EJ Nod Exchange gain under section 987 - Yes IJJ No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? — Yes M No


a Tainted property -Yes Ill Nob Depreciation recapture - Yes [xi] NoC Branch loss recapture - Yes EJ Nod Any other income recognition provision contained in the above-referenced regulations —Yes No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? — Yes 11X1 No

'15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section1 .367(a).1T(d)(5)(ii? - Yes LJ No

b If the answer to line 15a Is "Yes," enter the amount of foreign goodwill or going concern valuetransferred ' $

16 Was cash the only property transferred? EXJ Yes No



Form 926 (Rev. 12-2011)

22453305-01-12






I OMB No. 1545-0026


Identifying number(CCIflSCffOflS)



fewer domestic corporations? E] Yes Nob Did the transferor remain in existence after the transfer? . Yes No



c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? L..J Yes L....J NoIf not, list the name and employer identification number (EIN) of the parent corporation:



No




WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LXJ Yes L..J Noc Is the partner disposing of its entire Interest In the partnership? . Yes I1 Nod is the partner disposing of an interest in a limited partnership that is regularly traded on an established

securities market?Yes NoPart II I Transferee Foreign Corporation Information (see Instructions)3 Name of transferee (foreign corporation) 14 identifying number, If any

PACIFIC INDUSTRIAL SERVICES PTY LTD I5 Address (including country)LEVEL 31, 126-130 PHILLIP STREETSYDNEY NSW 2000, AUSTRALIA6 Country code of country of Incorporation or organizationAS


8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... LXJ Yes L......J NoLI-IA For Paperwork Reduction Act Notice, see separate instructions Form 926 (Rev. 12-2011)22453105-01-12


C CFomi926(Rev.12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 P1qe2I Part Ill I Information Regarding Transfer of Property (see instructions)


Cash

Stock andsecurities




Inventory



Intangibleproperty


Property to be sold(as described inTemp. Regs. sec.1 .367(a)-4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.Reos. sec. 1.367(a)-46

Other property


224532Form 926 (Rev. 12.2011)

05-01-12







a Gain recognition under section 904(f)(3) Ej Yes Nob Gain recognition under section 904(f)(5)(F) . Yes [X] NoC Recapture under section 1503(d) .Yes [] Nod Exchange gain under section 987 . Yes EXI No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? . Yes MI No


a Tainted property .Yes [XI Nob Depreciation recapture .Yes [Xi Noc Branch loss recapture . Yes EXI Nod Any other income recognition provision contained in the above-referenced regulations .Yes M1 No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? LI Yes IJJ No

15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section1 .367(a)-i T(d)(5)(ii? . Yes LJ No

b If the answer to line 15a is 'Yes,' enter the amount of foreign goodwill or going concern valuetransferred $

16 Was cash the only property transferred? II] Yes No

17 a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? . Yes [J No


Form 926 (Rev. 12-2011)

22453305-01-12


IsF. 926(Rev. December 2011)Department of the TreasuryIntern1 Revenue Service



Name of transferorTHE BIJOOMBERG FAMILY FOUNDATION INC

OMB No. 1545-0026


Identifying number (see jAsu$)



fewer domestic corporations? ................................................................................................................................. LJ Yes El No

b Did the transferor remain in existence after the transfer? ...........................................................................................Yes NoIf not, list the controlling shareholder(s) and their identifying number(s):


Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was It the parent corporation?L...J Yes L..J NoIf not, list the name and employer Identification number (EIN) of the parent corporation:




No



Name of partnership

EIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 26-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?LJJ Yes L......J No

C Is the partner disposing of its entire interest in the partnership? ................... L1 Yes EXI Nod Is the partner disposing of an Interest in a limited partnership that is regularly traded on an established -

Part II I Transferee Foreign Coma



PACIFIC INDUSTRIAL SERVICES 2 PTY LTD5 Address (including country)LEVEL 31, 126-130 PHILLIP STREETSYDNEY NSW 2000, AUSTRALIA6 Country code of country of Incorporation or organizationAS


8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... Lxi Yes LJ NoLHA For Paperwork Reduction Act Notice, see separate Instructions. Form 926 (Rev. 12-2011)22453105-01-12


A;

Form 926 (Rev. 12.2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Page 2I Part III I Information Regarding Transfer of Property (see instructions)

Type ofproperty

(a) (b) (C) (d) (e)Date of Description of Fair market value on Cost or other Gain recognized ontransfer I property I date of transfer I basis I trarisfAr

Stock andsecurities

Instalment obligations,account receivables orsimilar property


Inventory

Assets subject todepreciation recapture(see Temp. Regs. sec.I .367(a)-4T(b))Tangible property used intrade or business not listedunder another category

Intangibleproperty


Property to be sold(as described inTemp. Regs. sec.1 .367(a).4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.Reqs. sec. 1 .367(a-4T(E

Other property


224532 Form 926 (Rev. 12-2011)05-01-12


^A]THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483




11 indicate whether any transfer reported in Part ill is subject to any of the following:

a Gain recognition under section 904(f)(3) El Yes LX] Nob Gain recognition under section 904(t)(5)(F) El Yes LX] NoC Recapture under section 1503(d) El Yes M Nod Exchange gain under section 987 El Yes LJ No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? El Yes LXJ No


a Tainted property El Yes [] Nob Depreciation recapture L1J Yes LX] NoC Branch loss recapture El Yes EE No

d Any other income recognition provision contained In the above-referenced regulations El Yes EE No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? El Yes LX] No

15a Did the transferor transfer foreign goodwill or going concern as defined in Temporary Regulations section

1.367(a)-i T(d)(5)(iii)? El Yes LX] No

b If the answer to line 1 5a is Yes,' enter the amount of foreign goodwill or going concern valuetransferred $


17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? . Yes LX] No


Form 926 (Rev. 12-2011)

22453305-01-12


Fcrm 926(Rev. December 2011)Department of the TreasuryInternal Revenue Service




OMB No. 1545.0026

I AttachmentSeqenuce No.128



a if the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by S orfewer domestic corporations? . Yes ED No

b Did the transferor remain in existence after the transfer? [J Yes No



Identifying number

c if the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L.J Yes L.J NoIf not, list the name and employer identification number (E1N) of the parent corporation:



d Have basis adjustments under section 367(a)(5) been made? Li Yes

No



Name of partnership

EIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? ........................................ I I Yes LJ No

o Is the partner disposing of its entire interest in the partnership?

Yes XlNo

ci Is the partner disposing of an interest in a limited partnership that is regularly traded on an established

-

Part II I Transferee Foreign Corporation



TB HOLDINGS LTD CIE SCS 198-10697035 Address (including country)P.O. BOX 309, UGLND HOUSEGRAND CAYMAN, KY1-1104, CAYMAN ISLANDS6 Country code of country of incorporation or organizationCJ


8 Is the transferee foreign corporation a controlled foreign corporation? ........ ............................................................. L..J Yes LXJ NoLHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)22453105-01-12


Form 926(Rev.12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 205602483 PaI Part Ill I Information Regarding Transfer of Property (see instructions)

Type ofproperty

Stock andsecurities

(a) (b) (c) (d) (e)Date of Description of Fair market value on Cost or other Gain recognized ontransfer property date of transfer I basis transfer20/2012 1,596,953.

Installment obligations,account receivables orsin-afar property


Inventory



Intangibleproperty

Property to be leased(as described in finaland temp. Regs. sec.1 .367(a)-4(c))Property to be sold(as described inTemp. Regs. sec.1 .367(a).4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.Reas. sec. 1 .367(a-4T(E

Other property


224532Form 926 (Rev. 12.2011)

05-el-12


THE BLOOMBERG FAMILY

TION INC

20-5602483 3



10 Type of nonrecognition transaction (see Instructions) 00 . SECTION 351 TRANSACTION

11 Indicate whether any transfer reported in Part III is subject to any of the following:a Gain recognition under section 904(t)(3). Yes Eli Nob Gain recognition under section 904(l)(5)(F) . Yes LX] Noc Recapture under section 1503(d) . Yes LX] Nod Exchange gain under section 987 .Yes LX] No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? E] Yes LX] No

13 Indicate whether the transferor was required to recognize income under final and temporary Regulations sections1.367(a)-4 Through 1.367(a)-6 for any of the following:

a Tainted property .Yes LX] Nob Depreciation recapture . Yes LX] Noc Branch loss recapture .Yes LX] Nod Any other income recognition provision contained in the above-referenced regulations .Yes EX:i No


15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations sectiont367(a).1T(d)(5)(iii)? .Yes

b If the answer to line 15a Is "Yes," enter the amount of foreign goodwill or going concern valuetransferred $

LX]No

LX]No

16 Was cash the only property transferred? LX] Yes No

17 a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? iII] Yes 12 No


Form 926 (Rev. 12-2011)

22453305-01-12

23717171111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOTINDA BLOOMFA2

OMB No. 1545-0025


[JF. 926(Rev. December 2011)Department of the TreasuryInternal Revenue Service



Name of transferor

Identifying number (seeTHE BLOOMBERG FAMILY FOUNDATION INC



b Did the transferor remain in existence after the transfer? . Yes No



Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L.J Yes U NoIf not, list the name and employer Identification number (EIN) of the parent corporation:




No



Name of partnership

EIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LIaJ Yes UJ Noc Is the partner disposing of its entire interest in the partnership? . Yes EXI Nod Is the partner disposing of an Interest In a limited partnership that is regularly traded on an established -


4 Identifying number, If any

Al CAPITAL (I) CORPORATION5 Address (including country)P.O. BOX 309, UGL.AND HOUSEGRAND CAYMAN KY1 —1104, CAYMAN ISLANDS6 Country code of country of incorporation or organizationCJ


8 Is the transferee forei gn corporation a controlled foreign corporation? .....................................................................L......J Yes Lxi NoLHA For Paperwork Reduction Act Notice, see separate Instructions. Form 926 (Rev. 12.2011)22453105-01-12


C CForm 926(Rev.12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Paa


(a) (b) (c) (d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer I property date of transfer basis transfer

C'mqh 1 1.265.487.

Stock andsecurities



Inventory

Assets subject todepreciation recapture(see Temp. Regs. sec.1.367(a).4T(b))Tangible property used intrade or business not listedunder another category

Intangibleproperty


Other property


224532Form 926 (Rev. 12-2011)

05-01-12

23917171111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUDA BLOOMFA2

LA

E#THE BLOOMBERG FAMILY FOUNDATION INC

20-5602483

9 Enter the transferors interest In the foreign transferee corporation before and after the transfer:



11 Indicate whether any transfer reported In Part Ill is subject to any of the following:

a Gain recognition under section 904(0(3) . Yes U1 Nob Gain recognition under section 904(f)(5)(F) U Yes [I] No

c Recapture under section 1503(d) U Yes IXJ No

d Exchange gain under section 987 U Yes t: No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? U Yes EJ No


a Tainted property U Yes [X] Nob Depreciation recapture U Yes 1XJ No

C Branch loss recapture EJ Yes LJ No

d Any other Income recognition provision contained in the above-referenced regulations U Yes EJ No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? U Yes No

15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section1 .367(a)-i T(d)(5)(iii)? . Yes EI No


16 Was cash the only property transferred? L1 Yes U No

17 a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? U Yes EJJ No


Form 926 (Rev. 12-2011)

22453305-01-12


Fcm926(Rev. December 2011)Department of the TreasuryInternal Revenue Service


01,Attach to your Income tax return for the year of the transfer or distribution.


Elf

=026

28

Identifying number (see jflth.,JcOofls)

20-5602483If the transferor was a corporation, complete questions la through id. - -

a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 orfewer domestic corporations? ...........................................................................................................................

b Did the transferor remain In existence after the transfer?If not, list the controlling shareholder(s) and their Identifying number(s):

LJYes EJNOlYes ED No


Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? UI Yes L..J NoIf not, list the name and employer identification number (EIN) of the parent corporation:




No



Name of partnership

EIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I rJLC 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LJ Yes Q Noc Is the partner disposing of Its entire Interest in the partnership? El Yes [Xl No

d is the partner disposing of an interest in a limited partnership that is regularly traded on an establishedsecurities market? El Yes [Xl No

Part II I Transferee Foreign Corporation Information (see instructions)3 Name of transferee (foreign corporation) 14 Identifying number, if any

AIC COMPANY LTD. I 98-10349415 Address (including country)WALKERS CORPORATE SVCS LTD., WALKER HOUSE, 87 MARY STREET, GEORGE TOWNGRAND CAYMAN, KY1-9005, CAYMAN ISLANDS6 Country code of country of incorporation or organizationClJ.


8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... L_J Yes LX.J NoLHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)22453105.01.12


Form Y2G(Rev.12-2011) THE BIiOOMBERG FAMILY FOUNDATION INC 205602483 Paqe2I Part III I Information Regarding Transfer of Property (see instructions)

(a) (b) (c)(d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer property date of transfer basis I transferCash

L1,o3o,72.I 27,5Stock andsecurities




Inventory


Intangibleproperty


Other property


224532 Form 926 (Rev. 12-2011)05-01-12


1#1THE BLOOMBERG FAMILY FOUNDATION INC

20-5602483


(a) Before % (b) After -



a Gain recognition under section 904((3) EJ Yes [J Nob Gain recognition under section 904(f)(5)(F) . Yes IJJ No

c Recapture under section 1503(d) L] Yes [] Nod Exchange gain under section 987 El Yes [] No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? El Yes [J No


a Tainted preperty El Yes [X] Nob Depreciation recapture El Yes L] Noc Branch loss recapture El Yes [X] No

d Any other income recognition provision contained in the above-referenced regulations El Yes No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? El Yes E1 No

15a Did The transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section

1.367(a)-1T(d)(5)(iiD? El Yes EJJ No


16 Was cash the only property transferred? El Yes [J No

17 a Was intangible property (within the meaning of section 935(h)(3)(B)) transferred as a result of the transaction? El Yes [J No


Form 926 (Rev. 12-2011)

2245305-01-12



Identifying numberii551

IS

14926

(Rev. December 2011)Department of the Treasuryinternal Revenue Service


110- to your income tax return for the year of the transfer or distribution. AttachmentSequence No. 128

20-5602483If the transferor was a corporation, complete questions lathrough ld.


b Did the transferor remain in existence after the transfer?If not, list the controlling shareholder(s) and their Identifying number(s):


El Yes El NoEl Yes No

Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L......J Yes L..J NoIf not, list the name and employer Identification number (EIN) of the parent corporation:



No




WILL,ETT PRIVATE INVESTORS (TAX EXEMPT) I LLC

26-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?c Is the partner disposing of its entire interest In the partnership?d Is the partner disposing of an Interest in a limited partnership that is regularly traded on an established



WYes U NoEl Yes [J No


LANTIQ HOLDCO S.ARL5 Address (including country)412 F, ROUTE D'ESCHL-1030, LUXEMBOURG6 Country cede of country of incorporation or organizationLU


8 Is the transferee foreign corporation a controlled forei gn corporation? ..................................................................... L.J Yes LXJ NoLHA For Paperwork Reduction Act Notice, see separate Instructions. Form 926 (Rev. 12-2011)22453105-01-12


Form926(Rev.12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 205602483 Page2I Part Ill I Information Regarding Transfer of Property (see instructions)

Type ofpmperty

(a) (b) (c) (d) (e) -Date of Description of Fair market value on Cost or other Gain recognized ontransfer I property date of transfer I basis transfer

Stock andsecurities



Inventory


Intangibleproperty

Property to be leased(as described in finaland temp. Regs. sec.1.367(a)-4(c))Property to be sold(as described inTemp. Regs. sec.

Transfers of oil and gasworking Interests (asdescribed in Temp.Reos. sec. 1.367(64T((

Other property


224532 Form 926 (Rev. 12-2011)05-01-12


[A]THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 3

9 Enter the transferor's Interest In the foreign transferee corporation before and after the transfer:



11 Indicate whether any transfer reported In Part Ill is subject to any of the following:

a Gain recognition under section 904(f)(3) LJ Yes Nob Gain recognition under section 904(l)(5)(F). Yes No

C Recapture under section 1503(d) El Yes IX] Nod Exchange gain under section 987 . Yes LK] No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? El Yes Ell No


a Tainted property El Yes [] No

b Depreciation recapture El Yes []] NoC Branch loss recapture El Yes EXI No

d Any other income recognition provision contained in the above-referenced regulations El Yes IJ No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? El Yes iJ No


1 .367(a)-i T(d)(5)(iii)? El Yes M No

b If the answer to line 1 5a is "Yes, enter the amount of foreign goodwill or going concern valuetransferred $

16 Was cash the only property transferred? .1XI Yes El No

17 a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? El Yes [K] No


Form 926 (Rev. 12-2011)

22453305-01-12

24617171111 737725 BLOOMFANFND 2012.04040 THE BLOONBERG FAMILY FOUNDA ELOOMFA2

Form 926(Rev. December 2011)Department of the Treasuryinternal Revenue SaMoa




^tl

17A

OMB No. 1545-0026

AttachmentSequence iio. 128

Identifying number (seeInshJc(Ons)



fewer domestic corporations? [E Yes Nob Did the transferor remain In existence after the transfer? .Yes ED No



o If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L...J Yes L....IJIf not, list the name and employer identification number (EItJ) of the parent corporation:



No




WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC I 26-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LJ Yes Li No

c Is the partner disposing of its entire Interest in the partnership? .Yes FX7 Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established

securities market? Yea [] NnPart II I Transferee Foreign Corpo3 Name of transferee (foreign corporation)


GGC PUBLIC EQUITIES OPPORTUNITIES BLOCKER CORP. LTD. 1 98-05729565 Address (including country)WALKERS SPV LIMITED, WALKER HOUSE, 87 MARY STREETGEORGE TOWN, GRAND CAYMAN KY1-9 002, CAYMAN ISLANDS6 Country code of country of Incorporation or organizationCtJ


8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... Li Yes Lxi NoLI-IA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)22453105-01-12


Form 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 PaaeI Part III I Information Regarding Transfer of Property (see instructions)

(a) (b) (c) (d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer property date of transfer basis transferCash 1 653,573.

Stock andsecurities



Inventory


Intangibleproperty

Property to be leased(as described in finaland temp. Regs. sec.1 .367(a)4(c))Property to be sold(as described inTemp. Regs. sec.


Reps. sec. 1 .367(a.4T(E

Other property


224532 Form 926 (Rev. 12-2011)05-01-12


AJTHE BLOOMBERG FAMILY FOUNDATION INC

20-5602483

9 Enter the transferors interest in the foreign transferee corporation before and after the transfer:




a Gain recognition under section 904(0(3) E] Yes []1 No

b Gain recognition under section 904(0(5)(F) Eli Yes CX] Noc Recapture under section 1503(d) . Yes LXI Nod Exchange gain under section 987 . Yes LXI No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? . Yes LX] No


a Tainted property .Yes LX] Nob Depreciation recapture .Yes Noc Branch loss recapture .Yes No

d Any other income recognition provision contained in the above-referenced regulations Eli Yes EIJ No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? . Yes LJ No

15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section1.367(a)-1T(d)(5)(iii)? .Yes No

b If the answer to line 15a is "Yes,' enter the amount of foreign goodwill or going concern valuetransferred 10 . $

16 Was cash the only property transferred? CX] Yes Eli] No

17 a Was Intangible property (within the meaning of section 936h)(3)(B)) transferred as a result of the transaction? . Yes LXII No


Form 926 (Rev. 12.2011)

22453305-01-12


51.

Form 926(Rev. December 2011)Department of the TreasuryIntemul Revenue Service


p-Attach to your income tax return for the year of the transfer or distribution.


OMB No. 1545-0026

I AttachmentSequence No.128

Identifying number (see


a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 orfewer domestic corporations? ............................................................................................................................ Yes El No



Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? - L__J Yes L_J NoIf not, list the name and employer identification number (EIN) of the parent corporation:




No

2 It the transferor was a partner In a partnership that was the actual transferor (but is not treated as such under section 367), completequestions 2a through 2d.


Name of partnership

EIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LZJ Yes L.J No

c Is the partner disposing of Its entire interest in the partnership? El Yes [] Nod Is the partner disposing of an Interest Ina limited partnership that is regularly traded on an established

securitiesmarket? -------------- --- --------- - ----------- ---- --------- --- --------- - ----------------- - -------- -------------- ------- -------- ---- -------- ---- -------- -[J Yes L] NoPart II I Transferee Foreign Corpo3 Name of transferee (foreign corporation)


INFOR LUX BOND COMPANY5 Address (including country)412 F, ROUTE DtESCHL-1030, LUXEMBOURG6 Country cede of country of incorporation or organizationLU


8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... Li Yes Lxi NoLHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)22453105-01-12


EAFom926(Rev.12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 PaI Part III I Information Regarding Transfer of Property (see instructions)

(a) (b) (c) (d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer property date of transfer basis transferCash 948784.

Stock and

securities



Inventory

Assets subject todepreciation recapture(see Temp. Regs. sec.I .367(a).4T(b))Tangible property used intrade or business not listedunder another category

Intangibleproperty


Property to be sold(as described inTemp. Regs. sec.

Transfers of oil and gasworking Interests (asdescribed in Temp.Rens. sec. 1 .367(a-4T(E

Other property


224532 Form 926 (Rev. 12-2011)05-01-12

25117171111 737725 BLOOMFPJffFND 2012.04040 THE BLIOOMBERG FAMILY FOUNDA BLOOMFA2

THE BLOONBERG FAMILY FOUNDATION INC

20-5602483

9 Enter the transferors interest in the foreign transferee corporation before and after the transfer:




a Gain recognition under section 904(f)(3)[] Yes [Xl No

b Gain recognition under section 904(f)(5)(F) El Yes [XI Noc Recapture under section 1503(d) El Yes EKN.

d Exchange gain under section 987 El Yes EE No

12 Did this transfer resuft from a change in the classification of the transferee to that of a foreign corporation? El Yes [J No


a Tainted property El Yes No

b Depreciation recapture El Yes EXil Noc Branch loss recapture El Yes [J No

d Any other income recognition provision contained In the above-referenced regulations El Yes EJ No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? El Yes LJ No


1.367(a)-1T(d)(5)(ii? El Yes [J No

b If the answer to line 15a Is "Yes, enter the amount of foreign goodwill or going concern valuetransferred $

16 Was cash the only property transferred?[] Yes El No

17 a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? El Yes [X] No

b If "Yes, describe the nature of the rights to the intangible property that was transferred as a result of thetransaction:

Form 926 (Rev. 12-2011)

22453305-01-12






OMB No. 1545-0026


Identifying number (at IISIJ1}CtIOflS)

20-5602483If the transferor was a corporation, complete questions I a through 1d.

a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 orfewer domestic corporations? . Yes El No



c if the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L......J Yes L...J NoIf not, list the name and employer identification number (EIN) of the parent corporation:



No




WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC I 26-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?C Is the partner disposing of its entire interest in the partnership?

d Is the partner disposing of an interest in a limited partnership that is regularly traded on an establishedsecuritiesmarket? ................................................................................................................................................

Part II I Transferee Foreign Corporation Information see Instructions)

LJ Yes U NoEl Yes [Xi No

Name 01 transferee (foreign corporation) 14 Identifying number, if any

WILLETT PRIVATE INVESTORS TAX EXEMPT II LP 98-06787855 Address (including country)C/O WILLETT ADVISORS LLC, WALKER HOUSE, 87 MARY STREETGEORGE TOWN, GRAND CAYMAN KY1-9002, CAYMAN ISLANDS6 Country code of country of incorporation or organizationCJ


8 Is the transferee foreign corporation a controlled foreign corporation' ? ..................................................................... Lxi Yes L..J NoLHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12.2011)22453105-01-12


H4

EAForm 926(Rev.12.2011) THE BL100NBERG FAMILY FOUNDATION INC 20-5602483 PaPart III I Information Regarding Transfer of Property (see instructions)

(a) (b) (c) (d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer property date of transfer basis transferCash - 108,501,207.

Stock andsecurities




Inventory


Intangibleproperty


Property to be sold(as described in

Temp. Regs. sec.1 .367(a).4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.

Reris. sec. 1.367(a)-4T((

Other property


224532Form 926 (Rev. 12-2011)

05-01-12

25417171111 737725 BIOOMFAMFND 2012.04040 THE BLOONBERG FAMILY FOTJNDA BLOOMFA2

orm 926 (Rev. 12 .2011) THE BLOOMBERG FAMILY FOUNDATION INCPart IV I Additional Information Regarding Transfer of Property (see instructions9 Enter the transferor's interest in the foreign transferee corporation before and after the transfer


10 Type of nonrecognition transaction (see instructions) I0, SECTION 351 TRANSACTION

20-5602483

11 Indicate whether any transfer reported in Part III is subject to any of the following:a Gain recognition under section 904(f)(3) . Yes [K] No

b Gain recognition under section 904(t)(5)(F) El Yes [] No

c Recapture under section 1503(d) El Yes M Nod Exchange gain under section 987 El Yes [K] No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? EJ Yes IJJ No


a Tainted property El Yes Nob Depreciation recapture El Yes [K] No

c Branch loss recapture El Yes No

d Any other income recognition provision contained in the above-referenced regulations El Yes LJ No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? El Yes EXI No


1.367(a)-1T(d)(5)(iil)? El Yes EXI No

b if the answerto line iSa Is 'Yes,' enter the amount of foreign goodwill or going concern valuetransferred $

16 Was cash the only property transferred? [K] Yes El No

17a Was intangible property (within the meaning of section 936(h)(3)(13)) transferred as a result of the transaction? El Yes [J No


Form 926 (Rev. 12-2011)

224533o5-el-12


LA FA

Farm 926(Rev. December 2011)Department of the TreasuryInternal Revenue Service


01, Attach to your income tax return for the year of the transfer or distribution.AttachmentSequence No. 128

Name of transferor

Identifying number (see IflabucOofls)


If the transferor was a corporation, complete questions 1 a through 1 d.a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 or

fewer domestic corporations? ................................................................................................................................. 0 Yes U Nob Did the transferor remain in existence after the transfer? ............................ .......................... U Yes U No



Identifying number

o If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?t._i Yes L....J NoIf not, list the name and employer identification number (EIN) of the parent corporation:



d Have basis adjustments under section 367(a)(5) been made?L.....J Yes

No



Name of partnership

EIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pick up its pro rate share of gain on the transfer of partnership assets? LISJ Yes L..J No

c Is the partner disposing of its entire Interest in the partnership? U Yes No




MOSAIC ENERGY LTD.5 Address (including country)202-6TH AVENUE, SUITE 800CALGARY ALBERTA, CA T2P 2R9, CANADA6 Country code of country of incorporation or organizationCA


8 Is the transferee foreign corporation a controlled foreign corporation? ................................................... .................. L...l Yes Lxi No

LHA For Paperwork Reduction Act Notice, see separate Instructions. Form 926 (Rev. 12-2011)22453105-01-12


LE

LiJForm 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Page 2I Part ifi Information Regarding Transfer of Property (see instructions)

Type ofproperty

Stock andsecurities

(a) (b) (c) (d) (e)Date of Description of Fair market value on Cost or other Gain recognized ontransfer property date of transfer I basis transfer

25,195,160.



Inventory


Intangibleproperty


Property to be sold(as described inTemp. Regs. sec.1 .367(a).4T(d)Transfers of oil and gasworking interests (asdescribed in Temp.Rens. sec. 1 .367(a)-4T(E

Other property


224532 Form 926 (Rev. 12.2011)O5O1-12

25717171111 737725 BLOOMF.NFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2


9 Enter the transferor's Interest In the foreign transferee corporation before and after the transfer:


10 Type of nonrecognition transaction (see instructions) pop. SECTION 351 TRANSACTION

11 Indicate whether any transfer reported in Part Ill Is subject to any of the following:a Gain recognition under section 904(f)(3) . Yes [J No

b Gain recognition under section 904(f)(5)(F)[] Yes [] NoC Recapture under section 1503(d) . Yes 111 Nod Exchange gain under section 987 . Yes EXI No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation?[] Yes [J No


a Tainted property .Yes (]] Nob Depreciation recapture .Yes MI No

c Branch loss recapture E] Yes [] Nod Any other income recognition provision contained in the above-referenced regulations . Yes 1XI No


15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section1.367(a)-1T(d)(5)(ii? . Yes [J No


16 Was cash the only property transferred?[] Yes No

17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? Yes LJ No

b if 'Yes," describe the nature of the rights to the intangible property that was transferred as a result of thetransaction:

Form 926 (Rev. 12-2011)

22453305-01-12

25817171111 737725 BLOOMF.AMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BL100MFA2

,.926(Rev. December 2011)Depelinent of the TreasuryInternal Revenue Service

Return by a U.S Transferor of Propertyto a Foreign Corporation



DE

1 #1OMB No. 1545.0026


Identifying number (see ins,,uceonsi


a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 orfewer domestic corporations? E1 Yes No

b Did the transferor remain in existence after the transfer? El Yes ON.If not, list the controlling shareholder(s) and their identifying number(s):


c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L.....J Yes L..J NoIf not, list the name and employer identification number (El) of the parent corporation:


d Have basis adjustments under section 367(a)(5) been made? Li y No




WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LL,C 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LJ Yes L....J Noc Is the partner disposing of its entire interest in the partnership? El Yes [I] Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established

securities market? El Yes [li NoPart II I Transferee Foreign Corpo


AACP DEBT INVESTORS, L.P.5 Address (including country)CIO ASIA ALTERNATIVES MANAGEMENT,SAN FRANCISCO, CA 941116 Country code of country of incorporation or organization


20-8920779

ONE MARITIME PLAZA, SUITE 1000


B Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... L__J Yes Lxi NoLHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)22453105-01-12


Form 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 205602483 Pape2I Part III I Information Regarding Transfer of Property (see instructions)

(a) (b) (c) (d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer property date of transfer basis transferCash 317.311.

Stock andsecurities



Inventory



Intangibleproperty

Property to be leased(as described In finaland temp. Regs. Sec.1.367(a)-4(c))Property to be sold(as described InTemp. Regs. sec.1 .367(a)-4T(d))Transfers of oil and gasworking interests (asdescribed In Temp.

Other property


224532Form 926 (Rev. 12-2011)

05-01-12



20-5602483




11 Indicate whether any transfer reported in Part Ill is subject to any of the following:a Gain recognition under section 904(0(3) .Yes [I] Nob Gain recognition under section 904(t)(5)(F) .Yes ill NoC Recapture under section 1503(d) .Yes LX] Nod Exchange gain under section 987 . Yes IIJ No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? . Yes [J No


a Tainted property EJ Yes LX] Nob Depreciation recapture . Yes EXI NoC Branch loss recapture . Yes Nod Any other income recognition provision contained in the above-referenced regulations . Yes LX] No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? Yes EE No

15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section1.367(a)-1T(d)(5)(iiO? . Yes [IJ No

b If the answer to line 15a Is "Yes, enter the amount of foreign goodwill or going concern valuetransferred $

16 Was cash the only property transferred?[] Yes [IJ No

17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? Yes LX] No


Form 926 (Rev. 12-2011)

22453305-01-12


Form 926(Rev. December 2011)Department of the Trees unjIntemal Revenue Service


10-Attach to your Income tax return for the year of the transfer or distribution.AttachmentSequence No. 128

Name of transferor

Identifying number (see instructions)THE BLOOMBERG FAMILY FOUNDATION INC





Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L....J Yes L..J NoIf not, list the name and employer identification number (EIN) of the parent corporation:



d Have basis adjustments under section 367(a)(5) been made? ................................................................................. L_.J Yes

No



Name of partnership

EIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 26-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?LASJ Yes L.J No

o Is the partner disposing of its entire interest in the partnership? . Yes EK Nod Is the partner disposing of an interest in a limited partnership that Is regularly traded on an established

securitiesmarket? .................................................................................................................................................Yes EXI No



AACP TAX EXEMPT INVESTORS II, L.P. 98-06156995 Address (including country)C/O ASIA ALTERNATIVES MANAGEMENT, ONE MARITIME PLAZA, SUITE 1000SAN FRANCISCO, CA 941116 Country code of country of incorporation or organization


8 Is the transferee forei gn corporation a controlled foreign corporation? ..................................................................... L..J Yes LXJ NoLHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12.2011)22453105-01-12

26217171111 737725 BLOOMFANFND 2012.04040 THE BLOOMBERG FAMILY FOIJNDA BLOOMFA2

Form 926 (Rev. 12-20111 THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Page 2I Part III I Information Regarding Transfer of Property (see instructions)

(a) (b) (c) (d) (e)Type Of Date of Description of Fair market value on Cost or other Gain recognized onProperty transfer property date of transfer basis transfer

Cash 1,476,693.

Stock andsecurities



Inventory



Intangibleproperty

Property to be leased(as described In finaland temp. Regs. sec.1 .367(a)4(c))Property to be sold(as described inTemp. Regs. sec.1 .367(a)-4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.Recis. sec. 1 .367(a)-4T(E

Other property


224532Form 926 (Rev. 12-2011)

05•O1-12

26317171111 737725 BLOOMFMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOONFA2

THE BLOOMBERG FAMILY FOUNDATION INC 20T5602483




11 indicate whether any transfer reported in Part HI is subject to any of the following:a Gain recognition under section 904(t)(3) . Yes [XII Nob Gain recognition under section 904(t)(5)(F) . Yes [1 Noc Recapture under section 1503(d) . Yes 1X1 Nod Exchange gain under section 987 .Yes CE No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? . Yes EXII No

13 Indicate whether the transferor was required to recognize income under final and temporary Regulations sections1.367(a) .4 through 1.367(a)-6 for any of the following:

a Tainted property . Yes [J Nob Depreciation recapture EIJ Yes DJ NoC Branch loss recapture .Yes EK Nod Any other income recognition provision contained in the above-referenced re gulations £1111] Yes [J No


16a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section1.367(a)-1 T(d)(5)(iii)? .Yes


EJNo

IM No


17 a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? . Yes LJ No


Form 926 (Rev. 12.2011)

22453305-01-12

26417171111 737725 BLOOMFNFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOONFA2

Fcm 926(Rev. December 2011)Department of the TreasuryInternal Revenue Service


"Attach to your income tax return for the year of the transfer or distribution.


12

^Ili

OMB No. 1545-0026


ientifying number Instrucioss)

20-5602483If the transferor was a corporation, complete questions 1 a through id.

a If the transfer was a section 361 (a) or(b)transfer, was the transferor controlled (under section 368(c)) by 5 orfewer domestic corporations? .Yes EJ No

b Did the transferor remain in existence after the transfer? ...........................................................................................Yes El NoIf not, list the controlling shareholder(s) and their Identifying number(s):


Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? Li Yes L......J NoIf not, list the name and employer Identification number (EINQ of the parent corporation:




No



Name of partnership

EIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pickup its pro rata share of gain on the transfer of partnership assets? ............................................ [Xi Yes LJ No

c Is the partner disposing of Its entire interest In the partnership? .................................. Yes [I) Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established



ALTOR FUND III (NO. 2) LP j 98-05947145 Address (including country)P.O. BOX 730, 11-15 SEATON PLACEST. HELIER, JE4 OQH, JERSEY6 Country code of country of incorporation or organizationJE


8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... Li Yes LXI NoLHA For Paperwork Reduction Act Notice, see separate Instructions. Form 926 (Rev. 12.2011)22453105-01-12


1V 0Form 926(Rev.12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Paqe2(Part III (Information Regarding Transfer of Property (see instructions)

(a) (b) (C) (d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer I property date of transfer basis I transfer

849.229.

Stock andsecurities



Inventory


Tangible property used in

trade or business not listedunder another category

Intangibleproperty

Property to be leased(as described in finaland temp. Regs. sec.1.367(a)-4(c))Property to be sold(as described inTemp. Regs. sec.1 .367(a).4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.Reos. sec. 1 .367(aI-4T(E

Other property


224532Form 926 (Rev. 12-2011)

05-01-12

26617171111 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA ELOOMFA2

P1926 (Rev. 122011) THE BLOOMBERG FAMILY FOUNDATION INCIV I Additional Information Regarding Transfer of Property (see instructions)




20-5602483

11 Indicate whether any transfer reported in Part III is subject to any of the following:a Gain recognition under section 904(f)(3) . Yes [1 Nob Gain recognition under section 904(f)(5)(F) . Yes [K) Noc Recapture under section 1503(d) . Yes EU Nod Exchange gain under section 987 . Yes [K) No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? . Yes LJ No


a Tainted property . Yes [IX] Nob Depreciation recapture . Yes [K] NoC Branch loss recapture .Yes No

d Any other income recognition provision contained in the above-referenced regulations EIJ Yes [K) No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? EJ Yes W No

15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section1.367(a).1T(d)(5)(ili)? . Yes No

b If the answer to line 15a is 'Yes,' enter the amount of foreign goodwill or going concern valuetransferred $

16 Was cash the only property transferred? LX] Yes LIIIJ No

17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? [1 Yes LX] No


Form 926 (Rev. 12-2011)

22453305-01-12


Form 926 Return by a U.S. Transferor of Property(Rev. December 2011) to a Foreign CorporationDepartment or the TreasuryInternal Revenue Service 'Attach to your income tax return for the year of the transfer or distribution.

I Part I I U.S. Transferor Information (see instructions)


I OMB No. 1545•0026


Identifying number (see jnssi



fewer domestic corporations? El Yes El No

b Did the transferor remain in existence after the transfer? .................................................................................. El Yes El No



Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? 1_i Yes L_J NoIf not, list the name and employer identification number (EIN) of the parent corporation:



d Have basis adjustments under section 367(a)(5) been made? L..J yes

No



Name of partnership

EIN of partnership

WILLETT PRIVATE INVESTORS (TAX EXEMPT) I LLC 126-2359838b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LXJ Yes L...J Noc Is the partner disposing of its entire interest in the partnership? El Yes LX] Nod Is the partner disposing of an interest In a limited partnership that is regularly traded on an established

securities market? El Yes [I] NoPart II I Transferee Foreign Corporation Information (see instructions)

3 Name of transferee (foreign corporation) J 4 Identifying number, if any

AACP TAX EXEMPT INVESTORS III, L.P. I5 Address (Including country)C/O ASIA ALTERNATIVES MANAGEMENT, ONE MARITIME PLAZA, SUITE 1000SAN FRANCISCO, CA 941116 Country code of country of Incorporation or organization


8 Is the transferee foreign corporation a controlled foreign corporation? ......................................... ............................ L..J Yes LXJ NoLHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12.2011)224531O5O112


t 0Form 926 (Rev. 12 .2011) THE BIOOMBERG FAMILY FOUNDATION INC 20-5602483 Page 2


Type ofproperty

(a) (b) (c) (d) (e)Date of Description of Fair market value on Cost or other Gain recognized ontransfer I property I date of transfer I basis I transfer

Stock andsecurities



Inventory


Intangibleproperty

Property to be leased(as described In finaland temp. Regs. sec.1.367(a)-4(c3Property to be sold(as described inTemp. Regs. sec.1 .367(a)-4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.

Other property


224532Form 926 (Rev. 12-2011)

05-01-12

26917171111 737725 BLOOMFFND 2012.04040 THE BL100NBERG FAMILY FOUNDA BL100MFA2

LAIForm 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 205602483 Paqe3I Part IV I Additional Information Regarding Transfer of Property (see instructions)




11 Indicate whether any transfer reported In Part III Is subject to any of the following:

a Gain recognition under section 904(f)(3) El] Yes E] Nob Gain recognition under section 904(0(5)(F) ED Yes [J No

c Recapture under section 1503(d) El Yes [] Nod Exchange gain under section 987 El Yes EZ No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? El] Yes [l No


a Tainted property El] Yes [Xl Nob Depreciation recapture El Yes IXJ Noc Branch loss recapture El Yes Ill No

dAny other Income recognition provision contained in the above-referenced regulations El Yes []] No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? El Yes Ell No


1.367(a)-1 T(d)(5)(iü)? E:J Yes LXII No

b If the answer to line 15a Is Yes," enter the amount of foreign goodwill or going concern valuetransferred $

16 Was cash the only property transferred? IJ] Yes El No

17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? El Yes [XI No

b If "Yes, describe the nature of the rights to the Intangible property that was transferred as a result of thetransaction:

Form 926 (Rev. 12-2011)

22453305-01-12


Form 926(Rev. December 2011)Depeanent of the TreasuryInternal Revenue Service




01AB No. 1545.0026

ttachmentSequA ence No.128


20-56024831 if the transferor was a corporation, complete questions la through 1 d.


fewer domestic corporations? El Yes El Nob Did the transferor remain in existence after the transfer? ..........................................................................................[l Yes EJ No



Identifying number

o if the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation?L.....J Yes L.1 NoIf not, list the name and employer identification number (E1N) of the parent corporation:




No

2 if the transferor was a partner in a partnership that was the actual transferor (but is not treated as such under section 367), complete

questions 2a through 2d.a Ust the name and E1N of the transferor's partnership:

Name of partnership

EIN of partnership

WILLET SELECT INVESTORS (TAX EXEMPT) I LP 126-1634308b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? ............................................. LXJ Yes =No

c is the partner disposing of Its entire interest in the partnership? ............... ..

........................... El Yes No

d is the partner disposing of an interest in a limited partnership that is regularly traded on an established

securitiesmarket? ----- ------------- -------- ---------- - ----------- - ---- ----------------------- -------------------------- --------- ------------ -------- ------------ - El Yes [] NoPart II I Transferee Foreign Corpo



CULLIGAN HOLDINGS SARL5 Address (including country)15, RUE EDWARD STEICHEN, 4TH FLOORL-2440, LUXEMBOURG6 Country cede of country of incorporation or organizationLU


8 is the transferee foreign corporation a controlled forei gn corporation? ..................................................................... [Xi Yes L.J NoLHA For Paperwork Reduction Act Notice, see separate Instructions. Form 926 (Rev. 12-2011)22453105-01-12


Form 926(Rev.12.2011) THE BLiOOMBERG FAMILY FOUNDATION INC 205602483 Paqe2I Part III I Information Regarding Transfer of Property (see instructions)


Cash

Stock andsecurities


similar property


Inventory



Intangibleproperty


Other property


224532Form 926 (Rev. 12-2011)

05-01-12

27217171111 737725 BLOOMFAMFND 2012.04040 THE BLIOOMBERG FAMILY FOUNDA BLOOMFA2


9 Enter the transferor's interest in the foreign transferee corporation before and after the transfer-




a Gain recognition under section 904(f)(3) El Yes [] No

b Gain recognition under section 904(l)(5)(F) El Yes [] Noo Recapture under section 1503(d) . Yes [X] Nod Exchange gain under section 987 El Yes [J No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? El Yes LJ No


a Tainted property El Yes E2 Nob Depreciation recapture El Yes E2 No

C Branch loss recapture EIJ Yes EJ No

d Any other income recognition provision contained in the above-referenced regulations El Yes LJ No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? El Yes EXI No


1 .367(a)-i T(d)(5)(iii)? El Yes EJ No

b If the answer to line 15a is Yes," enter the amount of foreign goodwill or going concern valuetransferred 10. $

16 Was cash the only property transferred? E] Yes El No

17 a Was intangible property (within the meaning of section 936(h)(3)(6)) transferred as a result of the transaction? El Yes IJJ No

b If "Yes,' describe the nature of the rights to the intangible property that was transferred as a result of thetransaction:

Form 926 (Rev. 12-2011)

22452305-01-12

27317171111 737725 BLOOMFFND 2012.04040 THE ELOOMBERG FAMILY FOUNDA BLOOMFA2

No. 1545.0026


nName of transferor

THE BL100MBERG FAMILY FOUNDATION INCIdentifying number (see jnscions)

20-5602483

^ZF. 926(Rev. December 2011)Department of the TreasuryInternal Revenue Service


Attach to your Income tax return for the year of the transfer or distribution.

It the transferor was a corporation, complete questions 1 a through 1 d.

If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 orfewer domestic corporations? .Yes c:i No

b Did the transferor remain In existence after the transfer? EJ Yes EJ NoIf not, list the controlling shareholder(s) and their Identifying number(s):


C If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? .. L.J Yes L.....J NoIf not, list the name and employer identification number (EIN) of the parent corporation:



No




WILLET SELECT INVESTORS (TAX EXEMPT) I LP 1 26-1634308b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LXI Yes 17 No

C Is the partner disposing of its entire interest in the partnership? LJ Yes E]J Nod Is the partner disposing of an interest in a limited partnership that Is regularly traded on an established

securities market? 17 u.... lvi


A86-B INST SARL I 98-10705795 Address (including country)

41 AVENUE DE LA GAREL-1611, LUXEMBOURG6 Country code of country of incorporation or organizationLU


8 Is the transferee foreign corporation a controlled foreign corporation? ............................ .......................................... LXI Yes L...J NoLHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)22453105-01-12


CForm 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Page 2Part III Information Regarding Transfer of Property (see instructions)

(a) (b) (c) (d) (e) -Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer I property date of transfer basis transfer

Cash 09/20/20121 142,552.

Stock andsecurities



Inventory


Intangibleproperty

Property to be leased(as described in finaland temp. Regs. sec.1.367(a)-4(c))Property to be sold(as described inTemp. Regs. sec.1 .367(a)-4T(d))Transfers of oil and gasworking interests (asdescribed In Temp.Reos. sec. 1 .367(al-4T(

Other property


224532Form 926 (Rev. 12-2011)

05-01-12


,

Form 926(Rev.122O11) THE BLOOMBERG FAMILY FOUNDATION INC 205602483 Paqe3I Part IV I Additional Information Regarding Transfer of Property (see instructions)




11 Indicate whether any transfer reported in Part III is subject to any of the following:a Gain recognition under sebtion 904(t)(3) .Yes Nob Gain recognition under section 904(fX5)(F) ............................................................................................................. Yes [XI Noc Recapture under section 1503(d) . Yes Nod Exchange gain under section 987 .Yes L1 No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? . Yes EJ No


a Tainted property .Yes [XI Nob Depreciation recapture .Yes [XI Noc Branch loss recapture . Yes IJ Nod Any other Income recognition provision contained in the above-referenced regulations ........................................ Yes EJ No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? . Yes EX] No

15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section1.367(a).1T(d)(5)(iii)? ........................................................................................................................................ Yes EJ No



17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? Yes !JJ No


Form 926 (Rev. 12.2011)

22453305-01-12

27617171111 737725 BLOOMFAMFND 2012.04040 THE BL100MBERG FAMILY FOUNDA BLOOMFA2


number (See instrucliorts)

Rat

111

F. 926(Rev. December 2011)Department of the TreasuryInternal Revenue Service


00,Attach to your Income tax return for the year of the transfer or distribution.AttachmentSequence Ne. 128

20-56024831 If the transferor was a corporation, complete questions 1 a through 1 d. -


fewer domestic corporations? . Yes LJ Nob Did the transferor remain in existence after the transfer?... Yes E] No

If not, list the controlling shareholder(s) and their Identifying number(s):


Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? L._J Yes LJ NoIf not, list the name and employer identification number (EIN) of the parent corporation:



d Have basis adjustments under section 367(a)(5) been made? L_.J Yes

No


questions 2a through 2d.a List the name and EIN of the transferor's partnership:

Name of partnership

EIN of partnership

WILLET SELECT INVESTORS (TAX EXEMPT) I LP 26-1634308b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? L1J Yes L_J Noc Is the partner disposing of its entire interest in the partnership? . Yes []] Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established

securities market? LI Yes [] NoPart II I Transferee Foreign Corporation Information (see instructions)

3 Name of transferee (foreign corporation) j 4 Identifying number, if any

BDS3TESARL5 Address (including country)41 AVENUE DE LA GAREL-1611, LUXEMBOURG6 Country code of country of incorporation or organizationLU


8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... LXJ Yes Li NoLFIA

431 For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)

05-01-12


Am

so 0Form926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Page 2I Part III I Information Regarding Transfer of Property (see instructions)

(a) (b) (c) (d) (e)TYPO of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer property date of transfer basis transfer

04/04/20121 594881.

Stock andsecurities




Inventory


Intangibleproperty

Property to be leased(as described in finaland temp. Regs. sec.1 .367(a)4(c))Property to be sold(as described inTemp. Regs. sec.1 .367(a).4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.Reas. sec. 1.367(a)-4T((

Other property


Form 926 (Rev. 12-2011)22453205-01-12


EkForm 926(Rev. 12-20111 THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 P1ge3I Part IV I Additional Information Regarding Transfer of Property (see instructions)





a Gain recognition under section 904(0(3) ................................................................................................................... Yes [Xli Nob Gain recognition under section 904(f)(5)(F) Eli Yes [Xli No

c Recapture under section 1503(d) . Yes EU Nod Exchange gain under section 987 .Yes [Xli No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? . Yes Ell No

13 Indicate whether the transferor was required to recognize income under final and temporary Regulations sections

1.367(a) .4 through 1.367(a)-6 for any of the following:

a Tainted property . Yes [XI Nob Depreciation recapture . Yes LXI Noc Branch loss recapture .Yes MN.d Any other income recognition provision contained in the above-referenced regulations . Yes [Xli No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? Eli Yes [Xli No

15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section1 .367(a).1T(d)(5)(iii)? . Yes LXI No

b If the answer to line 15a is 'Yes," enter the amount of foreign goodwill or going concern value

transferred $



b If 'Yes," describe the nature of the rights to the intangible property that was transferred as a result of the

transaction:

Form 926 (Rev, 12-2011)

22453305-01-12


L2A

F.,. 926(Rev. December 2011)Department of the TreasuryIntemol Revenue Service


Aftach to your income tax return for the year of the transfer or distribution.

INC

I OMB No. 1545-0026


Identifying numberi5j0051

20-5602483

Name of transferorTHE BLOOMBERG FAMILY FOUNDATION

lithe transferor was a corporation, complete questions 1 a through 1d.a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 or

fewer domestic corporations? LJ Yes ETJ Nob Did the transferor remain in existence after the transfer? L] Yes No



Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was It the parent corporation? L_.J Yes LI NoIf not, list the name and employer identification number (EIN) of the parent corporation:



d Have basis adjustments under section 367(a)(5) been made? ................................................................... LI Yes

No



Name of partnership

EIN of partnership

WILLET SELECT INVESTORS (TAX EXEMPT) I LP 126-1634308b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?

LXJ Yes Li No

c Is the partner disposing of its entire interest in the partnership?

El Yes [XI Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established

Part If I Transferee Foreign Corpo



PTOLEMY III LP 198-05928515 Address (including country)P0 BOX 309, UGLAND HOUSE, SOUTH CHURCH STREETGEORGE TOWN, GRAND CAYMAN KY1-1104, CAYMAN ISLANDS6 Country code of country of Incorporation or organizationCJ


8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... LXJ Yes L.J NoLHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)22453105-01-12

28017171111 737725 BLOOMFANPND 2012.04040 THE BLOOMBERG FAMILY FOTJNDA BLOOMFA2

Form 926(Rev.12-2O11 THE BIJOOMBERG FAMILY FOUNDATION INC 20-5602483 Page 2



Cash 06/29/2012 256,011.

Stock andsecurities



Inventory


Intangibleproperty


Property to be sold(as described inTemp. Regs. sec.1 .367(a)4T(d))Transfers of oil and gasworking interests (asdescribed In Temp.

Other property


Form 926 (Rev. 12.2011)22453205-01-12

28117171111 737725 BLOOMFNFND 2012.04040 THE BLOOMBERG FAMILY FOtJNDA BLOOMFA2

EA I

Form 926(Rev.12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 205602483 Page3I Part IV I Additional Information Regarding Transfer of Property (see instructions)



10 Type of nonrecognition transaction (see instructions) lo. SECTION 351 TRANSACTION


a Gain recognition under section 904(0(3) El Yes t: No

b Gain recognition under section 904(0(5)(F) El Yes [1 No

c Recapture under section 1503(d) LJ Yes M No

d Exchange gain under section 987 EI Yes M No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? El Yes [X] No


a Tainted property El Yes [J Nob Depreciation recapture El Yes l]] No

C Branch loss recapture LJ Yes iJ No

d Any other income recognition provision contained in the above-referenced regulations El Yes EE No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? El Yes IJJ No

iSa Did the transferor transfer foreign goodwill or going concern value as defined In Temporary Regulations section

1.367(a)-1T(d)(5)(iii)? El Yes EJ No

b If the answer to line 15a Is "Yes,' enter the amount of foreign goodwill or going concern valuetransferred $


17a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? El Yes (]J No


Form 926 (Rev. 12-2011)

22453305-01-12


4

,.926(Rev. December 2011)Department or the TreasuryIntemal Revenue Service




0M13 No. 1545-0026





fewer domestic corporations? LI Yes El No

b Did the transferor remain in existence after the transfer? EI Yes i:j NoIf not, list the controlling shareholder(s) and their identifying number(s):


c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? L..J Yes L_J NoIf not, list the name and employer Identification number (EIN) of the parent corporation:


d Have basis adjustments under section 367(a)(5) been made? ................................................................................. Li Yes

No

2 if the transferor was a partner in a partnership that was the actual transferor (but is not treated as such under section 367), completequestions 2a through 2d.



WILLET SELECT INVESTORS (TAX EXEMPT) I LP 26-1634308b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LXJ Yes E:: -No

C Is the partner disposing of its entire interest in the partnership? El Yes [] Nod Is the partner disposing of an interest in a limited partnership that is regularly traded on an established

securities market? El Yes EXI No



STUDIO BOULOGNE SARL 198-06884415 Address (including country)20 RUE DE LE POSTEL-2346, LUXEMBOURG6 Country code of country of incorporation or organizationLU


8 Is the transferee foreign corporation a controlled foreign corporation? ..................................................................... LX.] Yes LJ NoLHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)22453105-01-12


Form926 (Rev. 12.2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 PaI Part Ill Information Regarding Transfer of Property (see instructions)

(a) (b) (c) (d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer property date of transfer basis transferCash

Stock andsecurities


similar property


Inventory


Intangibleproperty



Property to be sold(as described inTemp. Regs. sec.1 .367(a)4T(d))Transfers of oil and gasworking Interests (asdescribed in Temp.

Reqs. sec. 1 .367(a)4T(E

Other property


224532 Form 926 (Rev. 12-2011)05-01.12

28417171111 737725 BLOOMFMFND 2012.04040 THE BL,00MBERG FAMILY FOTJNDA BLOOMFA2

2THE BLOOMBERG FAMILY FOUNDATION INC

20-5602483




11 Indicate whether any transfer reported in Part III is subject to any of the following:a Gain recognition under section 904(0(3) .Yes Nob Gain recognition under section 904(0(5)(F) . Yes IX] Noc Recapture under section 1503(d) . Yes EJ Nod Exchange gain under section 987 . Yes EXI No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? . Yes E1 No


a Tainted property [I] Yes [X] Nob Depreciation recapture . Yes IZI NoC Branch loss recapture . Yes EJ Nod Any other income recognition provision contained In the above-referenced regulations . Yes L1 No



1.367(a)-1T(d)(5)(ii?ci:i Yes EJ No

b if the answer to line 15a is "Yes," enter the amount of foreign goodwill or going concern valuetransferred $


17 a Was intangible property (within the meaning of section 936( h)(3)(B)) transferred as a result of the transaction? EJ Yes EX] No


Form 926 (Rev. 12-2011)

224533a5-el-12

2851717111]. 737725 BLOOMFAMFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA BLOOMFA2

EAFarm 926(Rev. December 2011)Department of the TreasuryIntumal Revenue Service




I OMB No. 1545-0026


Identifying number(SCfjflSbflS)

20-56024831 If the transferor was a corporation, complete questions la through 1 d. -

a If the transfer was a section 361(a) or (b) transfer, was the transferor controlled (under section 368(c)) by 5 orfewer domestic corporations? . Yes El No

b Did the transferor remain in existence after the transfer? EJ Yes [11] NoIf not, list the controlling shareholder(s) and their identifying number(s):


Identifying number

o If the transferor was a member of an affiliated group filing a consolidated return, was It the parent corporation? L_J Yes L..J NoIf not, list the name and employer identification number (EIN) of the parent corporation:



d Have basis adjustments under section 367(a)(5) been made? ................................................................................. L_J Yes

No

2 if the transferor was a partner in a partnership that was the actual transferor (but is not treated as such under section 367), completequestions 2a through 2d.

a List the name and E1N of the transferor's partnership:

Name of partnership

EIN of partnership

WILLET SELECT INVESTORS (TAX EXEMPT) I LP 26-1634308b Did the partner pick up its pro rata share of gain on the transfer of partnership assets? LX] Yes LJ Noc is the partner disposing of its entire interest in the partnership? .Yes M Nod is the partner disposing of an interest in a limited partnership that is regularly traded on an established


WILLETT SELECT INVESTORS II LP5 Address (including country)C/O WILLETT ADVISORS LLC, 25 EAST 78TH STNEW YORK, NY 100756 Country code of country of incorporation or organization


83-0501786


8 is the transferee foreign corporation a controlled forei gn corporation? ..................................................................... LX] Yes L..J NoLHA For Paperwork Reduction Act Notice, see separate instructions. Form 926 (Rev. 12-2011)05-01-12


tForm 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 Page 2


(a) (b) (c) (d) (e)Type of Date of Description of Fair market value on Cost or other Gain recognized onproperty transfer I property date of transfer basis transfer

324.941.009.

Stock andsecurities




Inventory



Intangibleproperty

Property to be leased(as described In finaland temp. Regs. sec.1 .367(a-4(c))Property to be sold(as described inTemp. Regs. sec.1 .367(a)-4T(d))Transfers of oil and gasworking interests (asdescribed In Temp.

Other property


224532Form 926 (Rev. 12-2011)

05-01-12

28717171111 737725 BLOONF.ANFND 2012.04040 THE BLOOMBERG FAMILY FOUNDA ELOOMFA2

[jJTHE


20-5602483



10 Type of nonrecognition transaction (see instructions) Op. SECTION 351 TRANSACTION


a Gain recognition under section 904(t)(3) El Yes [] No

b Gain recognition under section 904(0(5)(F) El Yes [J No

c Recapture under section 1503(d) El Yes LJJ Nod Exchange gain under section 987 El Yes EE No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? El Yes EI No


a Tainted property E] Yes [X1 Nob Depreciation recapture El Yes [Ix] No

C Branch loss recapture El Yes [Xl No

d Any other income recognition provision contained in the above-referenced regulations El Yes IIJ No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? El Yes l]J No

15 a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section

1 .367(a)-i T(c)(5)(ji)V.................................................................................... El Yes EM No

b If the answer to line 15a is Yes," enter the amount of foreign goodwill or going concern valuetransferred $


17 a Was intangible property (within the meaning of section 936(h)(3)(B)) transferred as a result of the transaction? El Yes [J No


Form 926 (Rev. 12711)

22453305-01-12


LA

Form 926(Rev. December 2011)Department of the TreasuryInterna' Revenue Service




OMB No. 1545-0026


Identifying number (See



fewer domestic corporations? ............................................................................................................ El Yes El No

b Did the transferor remain In existence after the transfer? ............................................................................ El Yes El NoIf not, list the controlling shareholder(s) and their identifying number(s):


Identifying number

c If the transferor was a member of an affiliated group filing a consolidated return, was it the parent corporation? L._i Yes L -No,If not, list the name and employer identification number (EIN) of the parent corporation:




No



Name of partnership

EIN of partnership

WILLET SELECT INVESTORS (TAX EXEMPT) I LP 126-1634308b Did the partner pick up its pro rata share of gain on the transfer of partnership assets?

LJ Yes LJNo

c Is the partner disposing of its entire Interest in the partnership? El Yes LX] No


Part II J Transferee Foreign Corporation Inform3 Name of transferee (foreign corporation)


BVP-IV CAYMAN A LIMITED5 Address Cincluding country)P.O. BOX 309, tJGLAND HOUSE, SOUTH CHURCH STGEORGE TOWN, GRAND CAYMAN KY1-1104, CAYMAN ISLANDS6 Country code of country of incorporation or organizationCJ


8 Is the transferee forei gn corporation a controlled foreign corporation? ..................................................................... Lxi Yes LJ NoLHA For Paperwork Reduction Act Notice, see separate Instructions. Form 926 (Rev. 12.2011)


Form 926 (Rev. 12-2011) THE BLOOMBERG FAMILY FOUNDATION INC 20-5602483 PaI Part Ill I Information Regarding Transfer of Property (see instructions)


Cash

.I

Stock andsecurities



Inventory


Intangibleproperty

Property to be leased(as described in finaland temp. Regs. sec.1.367(a)-4(c))Property to be sold(as described InTemp. Regs. sec.1 .367(a)-4T(d))Transfers of oil and gasworking interests (asdescribed in Temp.Reas. sec. 1 .367(a)•4T(

Other property


Form 926 (Rev. 12-2011)22453205-01-12


I&THE BL100MBERG FAMILY FOUNDATI INC

20-5602483





a Gain recognition under section 904(f)(3) . Yes EJ No

b Gain recognition under section 904(f)(5)(F) L1 Yes EJ No

c Recapture under section 1503(d) [J Yes [I] No

d Exchange gain under section 987 El Yes [X] No

12 Did this transfer result from a change in the classification of the transferee to that of a foreign corporation? El Yes iJJ No


a Tainted property El Yes [] Nob Depreciation recapture El Yes [Cl NoC Branch loss recapture El Yes EJ No

d Any other income recognition provision contained in the above-referenced regulations El Yes E]] No

14 Did the transferor transfer assets which qualify for the trade or business exception under section 367(a)(3)? EI Yes

15a Did the transferor transfer foreign goodwill or going concern value as defined in Temporary Regulations section1.367(a).1T(d)(5)(iii)?[l Yes

b If the answer to tine 15a Is Yes," enter the amount of foreign goodwill or going concern valuetransferred $

IXJ No

EXI No

16 Was cash the only property transferred? El Yes EJ No

17 a Was intangible property (within the meaning of section 936(h)(3)(13)) transferred as a result of the transaction? El Yes lX1 No

b If Yes," describe the nature of the rights to the Intangible property that was transferred as a result of thetransaction:

Form 926 (Rev. 12-2011)

22453305-01-12


AwlTHE BLOOMBERG FAMILY F UNDATION INC 20-5602483

FORM 926 PART III - INFORMATION REGARDING STATEMENT 42TRANSFER OF PROPERTY

CASH

(A)

(C)DATE OF

FAIR MARKET VALUETRANSFER

ON DATE OF TRANSFER

12/07/2011

149,478.107,991.

257,469.


CASH

(A)

(C)DATE OF FAIR MARKET VALUETRANSFER

ON DATE OF TRANSFER

06/20/2012

691,210.07/18/2012

25,016.07/20/2012

4,800.

721,026.


CASH

(A)

(C)DATE OF

FAIR MARKET VALUETRANSFER

ON DATE OF TRANSFER

01/04/2012

1,139,533.08/17/2012

36,434.

1,175,967.

17171111 737725 BLOOMFAMFND292 STATEMENT(S) 42, 43, 44

2012.04040 THE BLOONBERG FAMILY FOUNDA BLOOMFA2

COPY OF WITHIN PAPERRECEIVED

NOV 2 2 2013

OFFICE OF THE ATTORNEY GENCHARITIES BUREAU

Bloomberg 2012

Documents

Transcript of Bloomberg 2012